Peritraumatic Distress, Dissociation, and ICU Memories in Relation to Post-Traumatic Stress Symptoms After Intensive Care

Background/Objectives: Psychological symptoms are common after intensive care. Early distress, dissociation, and disturbing ICU memories may contribute to later post-traumatic stress symptoms. This prospective observational study examined these relationships in adult ICU patients. Methods: Peritraumatic distress, dissociation, anxiety, depression, and ICU memories were assessed during the ICU stay. PTSD symptoms and HADS scores were assessed one month later. Sixty-eight patients were enrolled. Thirteen died before follow-up and two could not be reached. Follow-up data were available for 53 patients. Result: The mean one-month PCL-5 score was 16.1 ± 11.4. No participant reached the selected PCL-5 screening threshold of 47; this does not exclude clinical PTSD. Higher baseline PDI scores were associated with higher PCL-5 scores (r = 0.288, p = 0.037). Delusional ICU memories were also associated with higher PCL-5 scores (r = 0.326, p = 0.018). PDEQ scores were not significantly associated with PCL-5 scores. In the combined regression model, PDI, PDEQ, and delusional memories explained 17.1% of the variance in one-month PCL-5 scores (R2 = 0.171, p = 0.028). No individual predictor was significant in the primary three-predictor model. In a post hoc exploratory model additionally adjusting for baseline anxiety and depressive symptoms, PDI (p = 0.012) and delusional ICU memories (p = 0.027) were significant. Thus, the individual associations differed according to model specification. Conclusions: Early peritraumatic distress and delusional ICU memories may provide potentially informative indicators of subsequent post-traumatic stress symptom burden. These model-dependent findings require cautious interpretation and do not establish independent predictive utility.