Intensive care diaries to reduce of posttraumatic stress disorder for critical care patients-a systematic review with meta-analysis

Med Klin Intensivmed Notfmed. 2025 Jul 10. doi: 10.1007/s00063-025-01296-3. Online ahead of print.

ABSTRACT

BACKGROUND: Survivors of critical illness have an increased risk of psychological disorders such as posttraumatic stress disorder (PTSD), anxiety disorders or depression. A possible preventive intervention is an intensive care diary. The effect of intensive care diaries on the prevention of these psychosocial disorders remains unclear.

METHODS: In May 2024, a literature search with following metaanalysis was performed in PubMed, CINAHL, Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL) and PsychInfo databases based on the metaanalysis of Nydahl et al. (2018). Studies included were studies on intensive diaries with PTSD as the primary outcome and anxiety and depression as secondary outcomes. Study quality was assessed using the Cochrane Risk of Bias Tool 2 and the metaanalysis was performed with RevMan 5.4.1.

RESULTS: After reviewing 539 titles, 10 studies were included. The studies were of low to good quality. A total of three metaanalyses were performed. The metaanalysis for PTSD of intensive care patients (n = 1081; 9 studies) showed a significant reduction (OR 0.52 [95% CI: 0.28-0.98] p = 0.04; I² = 65%, τ² = 0.46, p = 0.005). Three studies with 427 patients were included in the metaanalyses of anxiety and depression. These showed no significant reduction in the HADS (anxiety: OR 0.55 [95% CI: 0.14-2.18] p = 0.40; I² = 74%, τ² = 1.08, p = 0.02; depression: OR 0.50 [95% CI 0.24-1.07] p = 0.08; I² = 34%, τ² = 0.17, p = 0.22).

CONCLUSIONS: Intensive care diaries may reduce the incidence of PTSD for patients after an ICU stay. However, no significant reduction can currently be shown for anxiety or depression.

PMID:40640577 | DOI:10.1007/s00063-025-01296-3