Imipramine Treatment in Pediatric Burn Patients With Symptoms of Acute Stress Disorder: A Pilot Study

Robert, Rhonda; Blakeney, Patricia; Villarreal, Cynthia; Rosenberg, Laura; Meyer, Walter J.

doi:10.1097/00004583-199907000-00018

Cited by 148 publications

(51 citation statements)

References 20 publications

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“…Robert et al 30 found that 10% of 403 children who were hospitalized for acute burn injury experienced "ASD symptoms" that lasted for at least 2 days, across multiple assessment points. DiGallo et al 21 assessed PTSD symptoms in 57 children 2 days to 2 weeks after the child was injured in a traffic crash.…”

Section: Discussionmentioning

confidence: 99%

Acute Stress Disorder Symptoms in Children and Their Parents After Pediatric Traffic Injury

et al. 2002

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ABSTRACT. Objective. The American Academy of Pediatrics highlights the important role of pediatricians in recognizing adverse child responses to tragic events, such as traffic crashes. One challenge in effectively identifying children and their parents with troubling psychological responses to trauma is that little is known about the normal range of acute psychological responses in children and their parents in the immediate aftermath of traumatic events, making identification of adverse child responses difficult. Within the first month after a traumatic event, individuals may display reexperiencing, avoidance, and hyperarousal symptoms as well as dissociation (eg, feelings of unreality or emotional numbing). The presence of these responses, collectively known as acute stress disorder (ASD), alerts providers to those who may be at risk for ongoing difficulties. For beginning to develop an evidence base to guide pediatric care providers in addressing acute traumatic responses, the aim of the current investigation was to describe systematically the range and type of symptoms of ASD in children and their parents after pediatric traffic injury.Methods. A prospective cohort study was conducted of traffic-injured children, who were 5 to 17 years of age and admitted to the hospital for treatment of injuries from traffic crashes, and their parents. All children who met eligibility criteria between July 1999 and May 2000 were invited to participate in the study. After consent/ assent was obtained, children and their custodial parents (or guardians) were interviewed within 1 month after injury via a structured assessment to determine the circumstances of the crash and the presence of ASD symptoms. Relevant demographic and clinical information (eg, age, race, gender, date of injury) was abstracted from the medical records of subjects. A survey instrument to assess the presence of ASD symptoms was completed by both the child and his or her guardian. All children completed the Child Acute Stress Questionnaire, and all parents completed the Stanford Acute Stress Reaction Questionnaire. Responses were scored for the presence of dissociation, reexperiencing, avoidance, and/or hyperarousal symptoms as well as broad distress (symptoms present in every category).Results. Symptoms of ASD were commonly observed in the children and parents. Eighty-eight percent of children and 83% of parents reported having at least 1 clinically significant symptom; this affected 90% of the families. Broad distress was observed for a large minority: 28% of children and 23% of parents. No statistically significant association was found between child broad distress and either child age (r ‫؍‬ ؊0.12) or child injury severity score (r ‫؍‬ ؊0.05). 2 analyses revealed no significant association between broad distress and child gender, child race, or mechanism of injury. No statistically significant association was found between parent broad distress and child age (r ‫؍‬ ؊0.06) or child injury severity score (r ‫؍‬ 0.09). 2 analyses revealed no significant ...

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Section: Discussionmentioning

confidence: 99%

Acute Stress Disorder Symptoms in Children and Their Parents After Pediatric Traffic Injury

et al. 2002

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“…In a pilot study with prospective, randomized, double-blind structure Robert et al [51] explored the effect of imipramine treatment of young patients with acute burns. It was assessed whether symptoms of acute stress disorder (ASD), potentially leading to PTSD, could be improved.…”

Section: Reviews On Psychopharmacotherapy Of Ptsd Among Children and mentioning

confidence: 99%

Posttraumatic Stress Disorder in Children and Adolescents: A Review of Psychopharmacological Treatment

Huemer

Erhart

Steiner

2010

Child Psychiatry Hum Dev

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The current paper aims at reviewing studies on psychopharmacological treatment of childhood and adolescent PTSD. Additionally, developmental frameworks for PTSD diagnosis and research along with an experimental model of quenching and kindling in the context of stress exposure are presented. We conducted an extensive literature search of reviews on psychopharmacotherapy as well as studies on psychopharmacological treatment for PTSD among children and adolescents. We used the database PubMed and focused on the time period of the last 10 years up to January 2009. Pertinent earlier papers were also included.There are a limited number of studies specifically assessing the psychopharmacological treatment of PTSD in children and adolescents. The vast majority of them lack verification in RCTs. Only the use of imipramine, divalproex sodium and sertraline were already evaluated in RCTs. Future studies should take into account developmental approaches to the diagnosis and treatment of PTSD in children and adolescents. In this context, different underlying neurobiological patterns, which are reflected in distinct clinical symptomatology, require a precise investigation and a symptom-orientated psychopharmacological approach.

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“…This study demonstrated that imipramine was superior to chloral hydrate in treating acute stress disorder in these children (Robert et al, 1999). Because of the recent FDA warnings associated with using these medications in children, they cannot be considered a first line treatment at this time.…”

Section: Evidence Base For Effective Early Interventionsmentioning

confidence: 90%

“…The few studies we have specifically in this regard are, not surprisingly, for children experiencing serious medical traumas (e.g., Robert, Blakeney, Villarreal, Rosenberg, & Meyer, 1999) or car accidents, since these are the types of traumas for which children are brought for immediate care. We have growing information about what factors put children at greatest risk for developing serious psychological difficulties following exposure to mass disasters (Pine & Cohen, 2002) and how to conduct large-scale screening for children and adolescents in the acute aftermath of such situations (Pfefferbaum et al, 1999).…”

Section: I S S E M I N a T I N G E A R L Y I N T E R V E N T I O N mentioning

confidence: 99%

Disseminating early interventions following trauma

Bisson

Cohen

2006

Journal of Traumatic Stress

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Dissemination of effective early interventions following trauma is necessary to ensure the provision of the best possible care in a timely manner. To achieve this, agreement from all key stakeholders is required regarding the messages to be disseminated and the means of dissemination. This article is based on a National Institute of Mental Health sponsored symposium on the dissemination of early interventions at the 21st annual meeting of the International Society for Traumatic Stress Studies in Toronto in 2005. The current knowledge base regarding the effectiveness and dissemination of early interventions (defined here as those that are begun within the first 3 months after exposure) following trauma for children, adolescents, and adults is considered.

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Imipramine Treatment in Pediatric Burn Patients With Symptoms of Acute Stress Disorder: A Pilot Study

Cited by 148 publications

References 20 publications

Acute Stress Disorder Symptoms in Children and Their Parents After Pediatric Traffic Injury

Acute Stress Disorder Symptoms in Children and Their Parents After Pediatric Traffic Injury

Posttraumatic Stress Disorder in Children and Adolescents: A Review of Psychopharmacological Treatment

Disseminating early interventions following trauma

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