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, PhD
Associate Professor, Psychiatry and Behavioral Sciences
Director, General Hospital Psychiatry Inpatient Consultation Service
Johns Hopkins Hospital
Co-Director, Johns Hopkins Anxiety Disorders Clinic and Residents' Outpatient Continuity Clinic
Johns Hopkins University School of Medicine

Christina Jones, RN, PhD
Nurse Consultant
Critical Care Rehabilitation
Whiston Hospital

Ramona O. Hopkins, PhD
Professor, Psychology and Neuroscience
Director, Neuroscience Center
Brigham Young University
Clinical Research Investigator, Pulmonary and Critical Care Division
Department of Medicine
Intermountain Medical Center
Center for Humanizing Critical Care
Intermountain Healthcare