Competing interestsThe authors declare that they have

Competing interestsThe authors declare that they have selleckchem no competing interestsAuthors’ contributionsTS conceived of the study, helped recruit the patients and wrote the manuscript. SBG participated in the design of the study, performed the statistical analysis and helped to draft the manuscript. AP helped to draft the manuscript. BDJ participated in the design of the study and helped to recruit the patients and draft the manuscript. RDS helped to draft the manuscript. VM helped to recruit the patients and draft the manuscript. PR helped to recruit the patients. CC helped to recruit the patients. HO helped to recruit the patients. PT participated in the design of the study and helped to draft the manuscript. KL participated in the design of the study, performed the measurement of plasma hormones levels and helped to draft the manuscript.

AcknowledgementsThe study was funded by Programme Hospitalier de Recherche Clinique grant AOM 01067.
Several studies have reported that patients who need intensive care unit (ICU) treatment may experience psychological distress with increasing development of psychological illness and morbidity related to psychological disorders [1-4]. The presence of anxiety, depression and posttraumatic stress disorder (PTSD) symptoms have been reported in three studies to have increased by 40%, 30% and 60%, respectively, in ICU survivors [1,4-6].The quality of life for critically ill patients after ICU treatment was found to be worst in patients who had undergone prolonged mechanical ventilation or had been admitted for severe trauma and sepsis [7].

Among critically ill patients, admission to the ICU as a result of major trauma may represent an additional risk factor because of the acutely stressful trauma experience. Studies which have followed ICU trauma patients after 1 year have reported a GSK-3 prevalence of PTSD symptoms of up to 30%, a prevalence up to 40% for anxiety and a prevalence up to 30% for depression [8-10]. Several factors (age and sex, duration of mechanical ventilation and ICU stay, unemployment, personality traits, factual and pain memory and educational status) have recently been associated with post-ICU psychological distress [4,11]. Recommendations available in the medical literature constitute only generic advisory statements on relational and psychological approaches to use with ICU patients without going into the mode, timing and characteristics of psychological intervention [12].

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