Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

After a critical illness, ICU diaries given to patients after discharge reduce symptoms of posttraumatic stress disorder

Parker AM, Sricharoenchai T, Raparla S, et al. Posttraumatic Stress Disorder in Critical Illness Survivors: A Metaanalysis. Crit Care Med. 2015;43:1121-9.

Review question

In adults who survive a critical (life-threatening) illness, can interventions prevent or reduce symptoms of posttraumatic stress disorder (PTSD)?


People who are critically ill are usually treated in intensive care units (ICUs).

PTSD can occur in people who were exposed to terrifying events. Symptoms may include severe anxiety, negative mood changes, flashbacks to the events, nightmares, or persistent, unwanted, and frightening memories.

After a critical illness, some people may develop symptoms of PTSD. Interventions may reduce the risk of getting PTSD or reduce symptoms of PTSD.

How the review was done

The reviewers did a systematic review, searching for studies that were published up to March 2014. They found 3 randomized controlled trials with 764 people.

The key features of the studies were:

  • people were adults who survived a critical illness;
  • interventions included ICU diaries, which were completed during the ICU stay and given to patients after discharge; a self-help rehabilitation manual; and a follow-up clinic led by nurses;
  • interventions were compared with usual care or no intervention; and
  • PTSD symptoms were assessed at least 1 month after people were discharged from the ICU and went home.

What the researchers found

Compared with usual care or no intervention:

  • ICU diaries reduced PTSD symptoms and the number of people who got PTSD by 3 months after ICU discharge;
  • a self-help rehabilitation manual reduced PTSD symptoms at 2 but not 6 months after discharge; and
  • a follow-up clinic led by nurses did not reduce PTSD symptoms at 6 or 12 months after discharge.


In adults who survive a critical illness, diaries completed in the ICU and given to patients after discharge reduced symptoms of posttraumatic stress disorder at 3 months. A follow-up clinic led by nurses did not reduce symptoms.

Effect of interventions to prevent PTSD or reduce PTSD symptoms in adults who survive a critical illness


Number of trials (people)

Effect of intervention on PTSD symptoms after discharge from the ICU

ICU diary

1 trial (352 people)

Reduced PTSD symptoms at 3 months

8 fewer people out of 100 (5% vs 13%) developed new PTSD at 3 months (from as few as 2 to as many as 15)

Self-help rehabilitation manual

1 trial (126 people)

Reduced PTSD symptoms at 2 months but not 6 months

Follow-up clinic led by nurses

1 trial (286 people)

No effect on PTSD symptoms at 6 months or 12 months

ICU = intensive care unit; PTSD = posttraumatic stress disorder.

*Interventions were compared with usual care or no intervention.

Related Topics


Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Evidence Summaries

Related Web Resources

  • Depression

    Informed Health Online
    Depression is a common mood disorder that can make it hard to cope with everyday life. Causes and risk factors for depression include genes, difficult experiences and life circumstances, chronic anxiety disorders, biochemical changes, medical problems, and lack of light. Psychological therapies (e.g., cognitive behavioral therapy) and medication, alone or combination, are treatment options.
  • Medicines for Treating Depression: A Review of the Research for Adults

    This patient decision aid helps adults diagnosed as being depressed decide on the type of medicine by comparing the benefits, risks and side effects of each antidepressant.
  • Patient education: Delirium (Beyond the Basics)

    UpToDate - patient information
    Delirium is the result of brain changes that lead to confusion, lack of focus and memory problems. There is no specific treatment for delirium - it is best to avoid risks, treat underlying illnesses and receive supportive care. Sedatives and physical restraints should be avoided.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Want the latest in aging research? Sign up for our email alerts.

Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.

© 2012 - 2020 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use