Objective. Major depressive disorder (MDD) is a common condition following treatment in the Intensive Care Unit (ICU). Long-term data on MDD in chronically critically ill (CCI) patients are scarce. Hence, the primary aim of the present study was to investigate the frequency and predictors of MDD after intensive care of CCI patients. Materials and Methods. In a prospective cohort study, patients with long-term mechanical ventilation requirements () were assessed with respect to a diagnosis of MDD, using the Structured Clinical Interview for DSM-IV, three and six months after the transfer from acute ICU to post-acute ICU. Sociodemographic, psychological, and clinical risk factors with values ≤ 0.1 were identified in a univariate logistic regression analysis and entered in a multivariable logistic regression model. A mediator analysis was run using the bootstrapping method, testing the mediating effect of perceived helplessness during the ICU stay, between the recalled traumatic experience from the ICU and a post-ICU MDD. Results. 17.6% () of the patients showed a full- or subsyndromal MDD. Perceived helplessness, recalled experiences of a traumatic event from the ICU, symptoms of acute stress disorder, and the diagnosis of posttraumatic stress disorder (PTSD) after ICU could be identified as significant predictors of MDD. In a mediator analysis, perceived helplessness could be proved as a mediator. Conclusions. Every fifth CCI patient suffers from MDD up to six months after being discharged from ICU. Particularly, perceived helplessness during the ICU stay seems to mainly affect the long-term evolvement of MDD. CCI patients with symptoms of acute stress disorder/PTSD should also be screened for MDD.

This study examined the validity of the South African Police Service (SAPS) multiple stressor intervention. The multiple stressor was developed for members of their specialised units to address Post Traumatic Stress Disorder (PTSD). Unfortunately, the SAPS multiple stressor intervention lacks scientific evidence to support its possible effectiveness in addressing PTSD. In the current study a deployment and intervention group was compared which employed a pre- test post-test design. The Davidson Trauma Scale and the Revised Impact of Event Scale measured PTSD globally, but also the PTSD dimensions of Intrusion, Avoidance/Numbing, and Hyperarousal. The Wilcoxon signed rank test results indicated that the intervention and deployment was both effective in addressing PTSD although the intervention group revealed the greatest improvement in their overall PTSD scores. The intervention group made significant progress in dealing with all three PTSD symptoms while the deployment group made less progress with their Intrusion and Avoidance/Numbing symptoms, but made significant progress with their Hyperarousal symptoms. The Mann-Whitney u test revealed no significant differences between the post intervention test scores of the two groups, either globally or on the three PTSD dimensions. It appears that deployment was just as effective as the multiple stressor intervention in addressing PTSD. / Psychology / M.A. (Psychology)

This study examined the validity of the South African Police Service (SAPS) multiple stressor intervention. The multiple stressor was developed for members of their specialised units to address Post Traumatic Stress Disorder (PTSD). Unfortunately, the SAPS multiple stressor intervention lacks scientific evidence to support its possible effectiveness in addressing PTSD. In the current study a deployment and intervention group was compared which employed a pre- test post-test design. The Davidson Trauma Scale and the Revised Impact of Event Scale measured PTSD globally, but also the PTSD dimensions of Intrusion, Avoidance/Numbing, and Hyperarousal. The Wilcoxon signed rank test results indicated that the intervention and deployment was both effective in addressing PTSD although the intervention group revealed the greatest improvement in their overall PTSD scores. The intervention group made significant progress in dealing with all three PTSD symptoms while the deployment group made less progress with their Intrusion and Avoidance/Numbing symptoms, but made significant progress with their Hyperarousal symptoms. The Mann-Whitney u test revealed no significant differences between the post intervention test scores of the two groups, either globally or on the three PTSD dimensions. It appears that deployment was just as effective as the multiple stressor intervention in addressing PTSD. / Psychology / M.A. (Psychology)