Psychological and Cognitive Impact of Critical Illness

Neuropsychiatric problems after critical illness are receiving increasing attention, particularly in the critical care medicine literature, but mental health and primary care clinicians should also be interested in these common problems, given the growing number of critical illness survivors who need care. Patients frequently come out of the intensive care unit (ICU) with horrifying distorted memories and don't understand what has happened to them. Not only are patients debilitated with ICU-acquired weakness and cognitive impairment, they are traumatized by actual experiences (e.g., shortness of breath and pain) and distorted memories (of being tortured, raped, assaulted, or imprisoned) shaped by delirium. Patients' family members are also frequently quite distressed, and children surviving critical illnesses appear to have similar experiences to adults. This book provides an overview of the nature and epidemiology of cognitive and other psychiatric problems in this growing population, and it addresses the small but growing literature on prevention and early intervention efforts. Addressing these problems successfully will require collaborative interventions, both in-ICU and post-ICU.

O. Joseph Bienvenu, MD, PhDAssociate Professor, Psychiatry and Behavioral SciencesDirector, General Hospital Psychiatry Inpatient Consultation ServiceJohns Hopkins HospitalCo-Director, Johns Hopkins Anxiety Disorders Clinic and Residents' Outpatient Continuity ClinicJohns Hopkins University School of Medicine
Christina Jones, RN, PhDNurse ConsultantCritical Care RehabilitationWhiston Hospital
Ramona O. Hopkins, PhDProfessor, Psychology and NeuroscienceDirector, Neuroscience CenterBrigham Young UniversityClinical Research Investigator, Pulmonary and Critical Care DivisionDepartment of MedicineIntermountain Medical CenterCenter for Humanizing Critical CareIntermountain Healthcare

Overview: Psychological and Cognitive Impact of Critical IllnessO. Joseph Bienvenu, Christina Jones, and Ramona O. Hopkins1. Personal journeys through understanding the psychological and cognitive problems faced by critical illness survivorsChristina Jones, Peter Gibb, and Ramona O. Hopkins2. Delirium in critically ill patientsMark van den Boogaard and Paul Rood3. Critical Illness and Long-term Cognitive ImpairmentRamona O. Hopkins, PhD, Maria E. Carlo, MD, James C. Jackson, PsyD4. Psychological impact of critical illnessO. Joseph Bienvenu and Christina Jones5. Rehabilitation psychology insights for the treatment of critical illness survivorsJennifer E. Jutte, James C. Jackson, and Ramona O. Hopkins 6. Prevention and treatment of posttraumatic stress and depressive phenomena in critical illness survivorsChristina Jones and O. Joseph Bienvenu7. Supporting pediatric patients and their families during and after intensive care treatmentGillian Coville8. Family Response to Critical IllnessJudy E. Davidson and Giroa Netzer