Psychological problems in intensive care.

Abstract

Intensive care units are now well established in modem hospital practice and there can be few clinicians in any specialty who have not had some of their patients treated in such units. Intensive care units form a collection of the most ill in hospital. In our own unit the average mortality based on the last 1700 patients admitted was 13-5%, although there was a wide variation depending on the type and number of diseases that individual patients had. Without the special care, technical skill, and resources that the unit provides, the mortality of these patients would have probably been about 80%O. Serious illness, of any sort, creates psychological problems for the patients-for example, the anxiety of the patient with ischaemic heart disease or the despair of the patient with obstructive lung disease are well known. Certain psychological problems, however, develop in patients in intensive care, which would appear to be particularly related to being in such a unit. Since patients may be referred into the unit from any medical or surgical discipline it is perhaps worth drawing attention to some of these psychological problems, particularly as occasionally they may be unexpectedly severe or bizarre.