As many as one in 4 people treated in an ICU go on to develop PTSD as a result of their admission. During the COVID-19 epidemic the number of people affected in this way has grown dramatically in line with increased ICU admissions caused by the pandemic.

Responding to this situation Oxford researchers supported by the Wellcome Trust and the NIHR Oxford Health Biomedical Research Centre (BRC) have published new guidance on how to apply Cognitive Therapy for PTSD (CT-PTSD), a NICE recommended psychological treatment.  Alongside this they have developed a suite of free resources for clinicians providing PTSD therapy, including COVID-19 specific materials for delivering therapy remotely.

Dr Hannah Murray, one of the research team behind this work, explains how patients leaving ICU can be affected: “post-ICU PTSD has distinctive features. It can include traumatic memories occurring following delirium experiences, which can include acute confusion, delusions and terrifying hallucinations”.

Cognitive therapy for PTSD is a first-line treatment with a strong evidence-base for effectiveness. When treating post-ICU patients, it is important to address the specific characteristics of post-ICU PTSD and to help patients with ongoing physical health needs, as well as psychological problems.

Dr Murray adds that psychological therapy services are likely to see increasing numbers of clients who have been affected by post-ICU PTSD, but, she explains, “until now, there has been little published clinical guidance to inform effective psychological therapy with this population”.

Created using clinical case examples the new guidance will bring direct benefit to patients. It will help clinicians to better understand how ICU experiences lead to PTSD and to better recognise PTSD in ICU patients. Coupled with the team’s free clinical resources the new guidance will help make the application of cognitive therapy for PTSD more widely available to patients who need it.