Jim Jackson Profile picture
Jan 31 5 tweets 2 min read
PTSD is a common phenomenon in ICU survivors, impacting literally millions of people around the world, every year. What do we know about it? A 🧵 1/5
In the late 1990s, research on #PTSD after the #ICU first emerged, with early studies suggesting prevalence rates of 40 to 50 percent, far higher than in combat veterans and other high risk groups. Studies since then have documented rates of 10% to 20% - clearly a problem. 2/5
Risk factors for PTSD in ICU survivors vary but include female sex, young age, a history of delirium, and a history of psychiatric illness. The presence of delusional memories also plays a role. @CIBScenter 3/5
Clinical expressions of PTSD after the ICU include fear and avoidance of medical procedures, disturbing memories of being critically ill, and intense preoccupation with reminders of trauma - often sounds, lights, ICU images, etc. 4/5
When ICU survivors with #PTSD get the empirically validated treatment they need, they do well. Generic mental health treatment is not adequate. Support groups help greatly. @CIBScenter 5/5

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More from @jcjackson68

Jan 31
Today on FaceBook, an old post popped up from a decade ago . . . 25 random things about me. I'll share some of them here in a 🧵.
1. I wish that I had had the opportunity to meet Dan Fogelberg before he passed away some years ago . . . his music comforts me and makes me wistful and nostalgic, especially his poignant classic “Same Auld Lang Syne.” @DanFogelberg2
2. One of my favorite memories growing up – as funny as it may sound – was watching Georgia Championship Wrestling on Saturday afternoons with my little brother. @RicFlairNatrBoy
Read 11 tweets
Jan 31
Executive dysfunction is common in survivors of #Covid_19 and #PICS but how is it expressed? Let's unpack the expressions of this condition in a 🧵. @CIBScenter @WesElyMD 1 of 5 Image
The 'sine qua non' of executive functioning is planning. Often measured using the WCST or the Tower Test. Deficts reflect an inability to formulate strategies, to take efficient routes, to anticipate needs in advance, to tackle problems systematically. @CIBScenter
Another key component is called "set shifting" - assessed on brief cognitive tests like the Trails B Test - it involves the ability to transition rapidly from one type of task to another, and then back again. Set shifting deficits interfere at home and work. @CIBScenter
Read 7 tweets
Jan 30
Cognitive Impairment in survivors of #LongCovid: A 🧵. Before the pandemic, I worked with survivors of critical illness in clinical/research contexts at the @CIBScenter and @ICU_Recovery. Since 2020, I've focused on neuropsychological issues in #LongCovid. What have we learned?
"Brain fog" might better be called "brain injury" as the cognitive impairment that impacts many #longhaulers is like a brain injury in nature - it happens abruptly, impacts a wide array of cognitive domains, often is not progressive, and may respond to rehabilitation. @CIBScenter
Cognitive impairment after #Covid can be related to illness severity, yes, but that doesn't mean that people with mild illness don't grapple with impairment. Indeed, cognitive deficits can be very profound and persistent in those who were not terribly sick. @CIBScenter
Read 7 tweets
Jan 30
🧵One of the most powerful developments of my life during my journey with #OCD has been "acceptance" but this process will benefit you in any circumstance. I'm sharing an acrostic I wrote about it. I hope it helps you, whatever your situation. @CIBScenter #LongCovid @WesElyMD
A – Acknowledge that your situation may never meaningfully change even though you might desperately want it to
C – Cut ties with a highly idealized view of the past that makes your current situation seem dire and unacceptable by comparison.
Read 11 tweets

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