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Medical Author:

Maureen Welker, MSN, NPc, CCRN

Maureen Welker, MSN, NPc, CCRN

Maureen Welker received a Bachelor of Science degree from California State University, Long Beach (CSULB) and also obtained a Public Health Nurse Certification. There she served as Vice President of the Graduate Nurses Association, at CSULB and also served as President of the Graduate Nurses Association. Ms. Welker is a board-certified Nurse Practitioner and is currently on staff at Mission Hospital Regional Medical Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is ICU psychosis?
• What causes ICU psychosis?
• What are the symptoms of ICU psychosis?
• How is ICU psychosis diagnosed?
• How is ICU psychosis treated?
• Can ICU psychosis be prevented?
• How long does ICU psychosis last?
• How common is ICU psychosis?
• What is an example of a situation of ICU psychosis?
• Can ICU psychosis be dangerous?
• ICU psychosis At A Glance
• ICU Psychosis Index

The primary goal is to correct any imbalance, restore the patient's health, and return the patient to normal activities as quickly as possible. To help prevent ICU psychosis, many critical care units are now:

• using more liberal visiting policies,

• providing periods for sleep,

• protecting the patient from unnecessary excitement,

• minimizing shift changes in the nursing staff caring for a patient, orienting the patient to the date and time,

• reviewing all medical procedures with an explanation about what to expect,

• asking the patient if there are any questions or concerns,

• talking with the family to obtain information regarding religious and cultural beliefs, and

• even coordinating the lighting with the normal day-night cycle, etc.

ICU psychosis often vanishes magically with the coming of morning or the arrival of some sleep. However, it may last 24 hours or even up to two weeks with fluctuations of the level of consciousness and behavior patterns. Although it may linger through the day, agitation frequently is worst at night. (This phenomenon, called sundowning, is also common in nursing homes).

Fortunately, ICU psychosis usually resolves completely when the patient leaves the ICU.

Some estimate that one patient in every three who spends more than five days in an ICU experiences some form of psychotic reaction. As the number of intensive care units and the patient population in them grow, the number of individuals affected by this disorder will correspondingly increase. With patients being transferred out of the ICU more rapidly than in years past; ICU psychosis may be more common in other areas such as the regular medical floor of the hospital or sometimes may even occur after discharge from the hospital.