Effect of intensive care unit diary on incidence of posttraumatic stress disorder, anxiety, and depression of adult intensive care unit survivors: A systematic review and meta‐analysis

Abstract

Aim: To systematically evaluate the effect of intensive care unit diary psychotherapy on the incidence of posttraumatic stress disorder, anxiety, and depression after discharge from intensive care unit.Background: Many studies have reported the potential advantages and risks of intensive care unit diary psychotherapy in adult patients discharged from intensive care unit, but the results are divergent. Design: Systematic review and meta-analysis of prospective randomized controlled or case-controlled studies. Data source: Databases such as Cochran Library, Pubmed, Embase, CINAHL, and ProQuest databases, China national knowledge infrastructure (CNKI) were searched for literatures published from January 2000-March 2020.Review methods: We use the Cochrane Risk of Bias Tool for quality assessment and audit manager 5.3 software for meta-analysis. The main result is the incidence of posttraumatic stress disorder, anxiety, and depression. Results:Ten studies meeting the inclusion criteria were identified, including eight randomized controlled studies and two case-controlled studies, with a total of 1,210 patients. The pooled results of this meta-analysis indicated that the intensive care unit diary could reduce the incidence of posttraumatic stress disorder, anxiety, and depression. Conclusion:This study showed that an intensive care unit diary could improve the psychological symptoms of adult intensive care unit patients after discharge. However, due to limitations such as publication bias and case sample size, the results should be carefully considered. Researchers need to further clarify the multidisciplinary collaborative process of intensive care unit diary therapy, the real beneficiaries, and its impact on family members' psychological status by conducting large, robust studies in the future.

The Effect of Intensive Care Unit Diaries on Posttraumatic Stress Disorder, Anxiety, and Depression

“…Two meta-analyses published in 2019 found no differences in PTSD 17,18 ; however, they did not include 2 recently published RCTs. Both these meta-analyses and another meta-analysis published in 2021 19 also included nonrandomized trials, therefore increasing risk of confounding and complicating the understanding of true effect. Our results are different from previous meta-analyses as we demonstrated a statistically significant improvement in PTSD symptoms in patients receiving an ICU diary, thanks to the inclusion of the last 2 RCTs.…”

“…10 However, recent RCTs published in 2020 [12][13][14][15] did not confirm these findings, possibly because of the small sample size or delta effect. 16 Three meta-analyses [17][18][19] were performed, but they also included retrospective cohort and before-andafter studies, or they did not include all the available RCTs. Therefore, we decided to conduct a systematic review and meta-analysis of RCTs to investigate the effects of ICU diaries on PTSD, depression, and anxiety of patients admitted to the ICU.…”

Post‐intensive care syndrome: Recent advances and future directions

“…ICU diaries, in which ICU staff record the events of a patient's stay in an ICU, have been shown to reduce the incidence of mental health problems. 30 However, early rehabilitation did not significantly improve mental health‐related outcomes. 31 …”

Schriftliche Begleitung einer existenziellen Erfahrung

“…Eine Metaanalyse inkludierte acht randomisierte kontrollierte Studien (RCT) und zwei kontrollierte Studien: Der Gebrauch von Intensivtagebüchern senkte im Vergleich zur üblichen Versorgung die Risiken für eine _ posttraumatische Belastungsstörung (PTBS; 9 Studien, 1174 Patientinnen: Odds-Ratio [OR]= 0,69; 95 %-Konfidenzintervall [95 %-KI] 0,51–0,93; p= 0,01) bei homogener Studienlage (I2=0 %, p= 0,46), _ Depression (6 Studien, 622 Patientinnen): OR= 0,56; 95 %CI 0,37–0,85; Die Autorinnen und Autoren diskutieren die möglichen Auswirkungen von Tagebüchern auf die PTBS-Prävention und -Behandlung angesichts einer komplexen Situation mit bzw. ohne wahnhafte, erschreckende Erinnerungen, dem Einfluss sedierender, ggf.delirogen wirkender Medikamente, dem Lesen vs. Vermeiden eines Tagebuchs, Familienunterstützung, Kultur und dem Zeitpunkt des Lesens [ 29 ]. Bezüglich des Lesezeitpunkts konnten Tripathy et al in einer randomisierten Studie mit 164 Patientinnen und Patienten keine wesentlichen Unterschiede im Hinblick auf Angst, Depression und PTBS ermitteln, wenn das Tagebuch nach einem oder nach drei Monaten gelesen wurde [ 30 ].…”