Dyadic post-traumatic stress after intensive care: Case report of a sepsis patient and his wife

Intensive Crit Care Nurs. 2020 Jun:58:102806. doi: 10.1016/j.iccn.2020.102806. Epub 2020 Feb 7.

Abstract

Introduction: Following intensive care treatment, patients and thier spouse often report traumatic memories that are frequently associated with post-traumatic stress symptoms. In this case report, we describe the case of a sepsis survivor and his wife who both suffered concurrently from intensive care associated post-traumatic stress symptoms as long-term sequelae. Both were treated with internet-based cognitive-behaviuoral writing therapy (iCBT) for post-traumatic stress disorder (PTSD) after intensive care.

Methods: Traumatic memories recalled during exposure in sensu as part of iCBT are described. Outcome data measured before, during and after psychotherapeutic treatment were analyzed.

Findings: Both, the patient and his wife showed characteristic symptoms of PTSD three years after discharge from the intensive care unit (ICU) comprising of intrusions, negative emotions, and hyperarousal. They reported unpleasant ICU memories from a patient's and relative's perspective, respectively. In both, the patient and his wife, a decline of symptoms with respect to all outcome measures during the course of iCBT from pre-treatment to three-month follow-up was observed.

Conclusion: Experiences of critical illness and intensive care can lead to post-traumatic stress in patients and their partners. Hence, it may be useful to offer mental health screening and psychotherapeutic treatment options to both ICU patients and their partners.

Keywords: Cognitive Behavioral Therapy; Intensive care; Internet; Post-intensive Care Syndrome; Post-intensive Care Syndrome-Family; Post-traumatic stress disorder; Sepsis; Spouses.

Publication types

  • Case Reports
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cognitive Behavioral Therapy / methods
  • Cognitive Behavioral Therapy / standards*
  • Cognitive Behavioral Therapy / statistics & numerical data
  • Female
  • Humans
  • Intensive Care Units / organization & administration
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Sepsis / complications
  • Sepsis / psychology*
  • Spouses / psychology*
  • Spouses / statistics & numerical data
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Survivors / psychology