Post-Intensive Care Syndrome: The Role of Geriatric Psychiatry in Research, Practice, and Policy

Wang et al.'s review of the Post-Intensive Care Syndrome (PICS) accomplishes three goals: 1. it describes PICS as an enormous public health problem with far-reaching consequences; 2. it summarizes gaps in knowledge about functional impairments in PICS; and 3. it envisions the role of geriatric psychiatry in clinical care and research to improve patient and family outcomes in PICS. The first point cannot be overstated. PICS consists of new or worsened physical, cognitive, and psychological impairments after critical illness. It affects more than half of the rapidly growing population of intensive care unit survivors and their families. And although PICS may be less a formal syndrome rooted in a common physiological mechanisms and more a marker of vulnerability, the named condition permits identification of canaries in the coal mine: individuals with existing functional impairments, at high risk of poor long-term outcomes, and vulnerable to every weak link at every transition along the healthcare chain.