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Vollständiger Abstract

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<h4>Background</h4>Post-Intensive Care Syndrome (PICS) is common among intensive care unit (ICU) survivors and is frequently accompanied by post-traumatic stress disorder (PTSD), anxiety and depression. ICU diaries are used to help survivors reconstruct fragmented ICU memories, but their effects on mental health outcomes remain uncertain.<h4>Aim</h4>To evaluate the efficacy of ICU diaries in mitigating PTSD, anxiety and depression among adult ICU survivors.<h4>Study design</h4>This systematic review and meta-analysis included randomized and non-randomized controlled studies. PubMed, Embase, Web of Science, the Cochrane Library, VIP, Wanfang Data and CNKI were searched from inception to 1 December 2025. Risk of bias was assessed using RoB 2 and ROBINS-I. Random effects meta-analyses were performed. Publication bias was examined using Egger's test and the trim-and-fill method. Trial sequential analysis (TSA) and GRADE assessment were also conducted.<h4>Results</h4>Twenty-one studies (17 RCTs and 4 NRCTs) involving 2180 participants were included. After trim-and-fill correction for publication bias, ICU diaries showed no statistically significant effect on PTSD incidence (adjusted RR 0.73, 95% CI [0.47, 1.12]) or PTSD severity (adjusted SMD -0.23, 95% CI [-1.20, 0.75]). Modest benefits persisted for anxiety and depression symptoms. Substantial heterogeneity was observed across studies (I 2 ranging from 0% to 95%). Subgroup analyses suggested that healthcare-professional-led diaries (without family involvement) were superior in reducing PTSD symptom severity.<h4>Conclusions</h4>After adjustment for publication bias, ICU diaries did not show statistically significant benefits for PTSD incidence or severity but may provide modest adjunctive benefits in alleviating anxiety and depression symptoms.<h4>Relevance to clinical practice</h4>ICU diaries may serve as a low-cost, humanistic adjunct to post-ICU psychological support for mental health outcomes. They should not be used as a standalone intervention for any single outcome. Standardized protocols and large trials using consistent outcomes of PTSD, anxiety and depression are needed.<h4>Review registration</h4>The protocol for this systematic review and meta-analysis was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD420251239895).

Abstract: PubMed · Datensatz