ICU psychosis is a condition experienced by patients in intensive care units or similar hospital environments, where they may feel anxious, paranoid, hear voices, see hallucinations, become disoriented, and even agitated or violent. It is clinically described as an "acute brain syndrome" leading to impaired cognitive function in patients receiving intensive care. This is a type of acute brain failure, or delirium, often triggered by factors such as dehydration, low oxygen levels, insufficient blood flow, infections, and medication.The treatment for ICU psychosis varies based on its underlying cause. Supportive measures like the presence of family, familiar items, and soothing communication can be beneficial. Rehydration is essential for dehydration, heart conditions require treatment with digitalis, infections need to be identified and managed, and sedation with antipsychotic drugs may be appropriate.To reduce the occurrence of ICU psychosis, many intensive care units now allow visiting hours, attempt to maintain consistent nursing staff for patients, and synchronize lighting with natural day-night cycles. ICU psychosis typically resolves once the patient leaves the ICU environment.Current estimates suggest that one in three patients who spend over five days in an ICU will experience some form of psychotic reaction. As the number of ICUs and patients increases, ICU psychosis is becoming a more prevalent issue. The exact causes of ICU psychosis are not fully understood, but it is believed that certain factors contribute to the condition. These include sensory deprivation from isolation, sensory overload from constant machine noise, inadequate pain management, sleep deprivation, disruption of natural circadian rhythms, and the loss of autonomy that patients often feel in an ICU.ICU psychosis often dissipates with sleep or daylight, though severe agitation is more common at night. This nighttime phenomenon, known as "sundowning," is also frequently observed in nursing homes.
