Comparative validation of three screening instruments for posttraumatic stress disorder after intensive care

Abstract

PurposeAim of the present study was to compare the validity of three screening instruments to assess symptoms of posttraumatic stress disorder (PTSD) after intensive care of sepsis. Material and methodsParticipants were recruited within a large multicenter patient cohort study on long-term sequelae of sepsis. Adult patients (n = 83) on average four months after intensive care of (severe) sepsis or septic shock were included (median age 64 years, 60% male). PTSD symptom severity was assessed by three different self-report measures: two versions of the Posttraumatic Stress Scale (PTSS-10; PTSS-14), and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). A clinical PTSD diagnosis was derived by using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). ResultsTen patients (12%) were diagnosed with PTSD. PTSS-10, PTSS-14, and PCL-5 revealed good reliability and concurrent validity. PTSS-14 showed the best accuracy in screening patients at risk for PTSD after intensive care with 80% sensitivity and 92% specificity at the recommended cutoff of 40. ConclusionsCompared to PTSS-10 and PCL-5, PTSS-14 appeared more appropriate for post-ICU PTSD screening when validated against a DSM-5 diagnostic interview.