Psychiatric outcome following paediatric intensive care unit (PICU) admission: a cohort study

Abstract

Post traumatic stress disorder diagnosis and symptomatology is significantly more common in families where a child has been admitted to the PICU. Consideration should be given to providing psychological support for children and parents after PICU admission.

Post-traumatic Stress Response to Life-Threatening Illnesses in Children and Their Parents

“…A group of 35 children, and their parents, who had been hospitalized in a pediatric ICU were compared with 33 children/parent pairs who had been hospitalized on general pediatric wards; 21% of pediatric ICU-discharged children developed PTSD compared with none of the ward admissions. Pediatric ICU children had significantly more PTSD features of irritability and persistent avoidance of reminders of the admission [13]. In another study, 22% of 143 children 7 to 15 years old who experienced motor vehicle injury met criteria for PTSD.…”

“…At follow-up 2 months later with 161 of the parents, 21% met symptom criteria for PTSD [16]. A British study found that parents of children hospitalized in the ICU were more likely to screen positive for PTSD (27%) compared with parents of children admitted to the ward (7%) [13]. In another study of mothers of children experiencing acute life-threatening illness, 111 mothers of children who survived hematopoietic stem cell transplantation completed self-report measures of psychological functioning at the time of hematopoietic stem cell transplantation and self-report measures and a structured psychiatric interview 18 months later.…”

Impact of Pediatric Critical Illness and Injury on Families: A Systematic Literature Review

“…* The authors of several cohort-comparison studies attempted to elucidate the difference between family impact in life-threatening and non-life-threatening disease states. 31,41,71,73,74 Sample sizes varied markedly (range: 7-189 families), and many were anecdotal. Most studies described findings in cohorts that were largely white and excluded non-English-speaking families.…”

“…This limitation is a crucial deficit and vital to note when planning future research. In addition, most family-impact data have been obtained from mothers, 12,63,67,69,71,74,75 although one study was conducted solely with fathers. 31 A substantial number of studies have focused on children who were in the PICU for the first time.…”

“…31 A substantial number of studies have focused on children who were in the PICU for the first time. 58,60,67,[69][70][71]74,76,77 Eight studies compared families of children who were admitted emergently to the PICU to those admitted who were admitted nonurgently. 31,50,60,61,69,70,76,77 We reviewed 18 articles that described the psycholog- ical impact on families of children with critical illness and injury (Table 3).…”