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. 2012 May 14;16(3):R80.
doi: 10.1186/cc11338.

Gender differences in psychological morbidity and treatment in intensive care survivors--a cohort study

Anna Schandl, Matteo Bottai, Elisabeth Hellgren, Örjan Sundin, Peter Sackey

Gender differences in psychological morbidity and treatment in intensive care survivors--a cohort study

Anna Schandl et al. Crit Care. .

Abstract

Introduction: Many hospitals have initiated follow-up to facilitate rehabilitation after critical illness and intensive care, although the efficacy of such an intervention is uncertain. Studies in trauma research indicate significant differences in psychological reactions to traumatic events between men and women. Our aim, in a quasi-experimental design, was to compare psychological morbidity and treatment effects between men and women enrolled in a multidisciplinary intensive care unit (ICU) follow-up programme (follow-up group) and ICU patients not offered such follow-up (control group).

Methods: Men and women treated more than four days in the ICU in 2006, before ICU follow-up started, were compared with men and women treated in 2007 and 2008, when all patients with an ICU stay of more than four days were offered ICU follow-up at 3, 6 and 12 months post-ICU. Fourteen months after ICU discharge, psychological problems were measured with Impact of Event Scale (IES) for posttraumatic stress and Hospital Anxiety and Depression Scale (HADS) for anxiety and depression.

Results: Women with no follow-up reported significantly higher IES scores than men. Women in the follow-up group reported significantly lower IES scores compared to women in the control group, both in crude analysis and after adjusting for significant confounders/predictors (age, ICU length of stay and previous psychological problems). Furthermore, the 75th percentile for IES and HADS-Depression scores (high scores and degree of symptoms of psychological problems) in women in the follow-up group was lower than in those without follow-up (IES: -17.4 p, P <.01, HADS-depression: -4.9 p, P <.05). For men, no significant differences were found between the no follow-up and the follow-up group.

Conclusion: Psychological problems after critical illness and intensive care appear to be more common in women than in men. A multidisciplinary ICU follow-up may reduce the incidence of long-term symptoms of posttraumatic stress and depression for women.

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Figures

Figure 1
Figure 1
Time points for patient enrolment. ICU = Intensive Care Unit.
Figure 2
Figure 2
Flow diagram of patient recruitment for control group and follow-up group. ICU = Intensive Care Unit
Figure 3
Figure 3
Organization of the multidisciplinary ICU follow-up programme. ICU, Intensive care unit; IES, Impact of Event Scale; HADS, Hospital Anxiety and Depression Scale
Figure 4
Figure 4
Median and interquartile range* for each outcome in controls (left-hand line) and follow-up (right-hand line). *adjusted for age, ICU- length of stay and previous psychological problems
See this image and copyright information in PMC

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