Patients receiving long-term mechanical ventilation are at great risk of developing psychological problems. Many factors known to precipitate psychological disturbances in the critically ill patient (i.e., severe illness, chronic disease, pharmacologic agents, etc.) are commonly present in the ventilator-dependent patient. In addition, dependence on a machine for life support that restricts mobility and complicates communication further compounds the problem.
This review integrates information regarding psychological problems in patients with critical illnesses, chronic diseases, and pulmonary disorders with the limited data that currently exist relative to patients receiving mechanical ventilation. Furthermore, we use this information to develop a strategy for the evaluation and treatment of psychological disorders in the ventilator-dependent patient.