Dtsch Arztebl Int
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Multiple studies have shown a link between cumulative adverse experiences in childhood and a wide variety of psychosocial problems in later life. There have not been any pertinent representative studies of the German population until now. The goal of this study is to determine the frequency of adverse childhood experiences (ACE), the extent to which they manifest themselves in patterns of co-occurrence, and their possible connection to psychosocial abnormalities in the German population. ⋯ Adverse childhood experiences are common, and their cumulation is associated with markedly increased negative sequelae for the affected persons. Preventive approaches are needed that extend beyond the area of child maltreatment alone and address other problems in the parental home, such as mental illness in the parents. Data acquisition by self-reporting is a limitation of this study.
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Illnesses that necessitate intensive care can impair cognitive function severely over the long term, leaving patients less able to cope with the demands of everyday living and markedly lowering their quality of life. There has not yet been any comprehensive study of the cognitive sequelae of critical illness among non- surgical patients treated in intensive care. The purpose of this review is to present the available study findings on cognitive deficits in such patients, with particular at- tention to prevalence, types of deficit, clinical course, risk factors, prevention, and treatment. ⋯ Cognitive dysfunction is a common sequela of the treatment of non-surgical patients in intensive care units. It is a serious problem for the affected persons and an increasingly important socio-economic problem as well. The effective management of delirium is very important. General conclusions are hard to draw from the available data because of heterogeneous study designs, varying methods of measurement, and differences among patient cohorts. Further studies are needed so that study designs and clinical testing procedures can be standard- ized and effective measures for prevention and treatment can be identified.