Troubles psychiques des malades pendant et après leur séjour en réanimation

Abstract

Stays in intensive care units (ICUs) are a source of psychological and physical stress, sometimes resulting in psychological disorders that may persist after ICU discharge. ICU stressors include exhaustion, drug-induced sleep privation, intubation, pain, noise, and a disrupted light-dark cycle. Patients remember traumatic experiences, such as a fear of being killed or abandoned, nightmares, and panic attacks. Depression is frequent but difficult to detect. Psychiatric disorders such as delirium and confusion (hallucinations, agitation, stupor) occur in almost half of all ICU patients. Simple measures can reduce the risk of such disorders, including noise reduction, less intense lighting (especially at night), individual rooms, visible clocks to reduce confusion, frequent family visits, verbal contact, reassurance, and anxiolytics. Anxiety and depression are frequent after ICU stays, and may be mixed with post-traumatic stress disorder (PTSD), which can include fear, feelings of horror, helplessness, avoidance, neurovegetative symptoms, and intrusive thoughts. New techniques are being tested to prevent these disorders, such as logbooksfor families and team members to note events during and after the ICU stay, and end-of-stay psychological OK? consultations for both the patient and the family.