Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Intensive Care Medicine
Published in: Intensive Care Medicine 8/2004

01-08-2004 | Neonatal and Pediatric Intensive Care

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

Authors: Gwyneth Rees, Julia Gledhill, M. Elena Garralda, Simon Nadel

Published in: Intensive Care Medicine | Issue 8/2004

Login to get access

Abstract

Objective

To determine whether paediatric intensive care unit (PICU) admission is associated with greater psychiatric morbidity in children and parents as compared with general paediatric ward admissions.

Design

Retrospective cohort study.

Setting

Paediatric intensive care unit and two general paediatric wards of a London teaching hospital.

Participants

Children aged 5–18 years discharged from PICU (exposed cohort) and general paediatric wards (unexposed cohort) 6–12 months previously, together with their parents.

Measurements and results

Children: the Clinician Administered Post Traumatic Stress Disorder (PTSD) Scale for Children (CAPS-C), the Impact of Event Scale (IES), Strengths and Difficulties Questionnaire, Birleson Depression Scale, Revised Children’s Manifest Anxiety Scale, Child Somatization Inventory. Parents: IES, General Health Questionnaire, Beck Depression Inventory, Hospital Anxiety and Depression Scale. Thirty-five of 46 (76%) PICU-discharged families and 33 of 41 (80%) from general paediatric wards participated. Valid CAPS-C data were obtained for 19 PICU-admitted children and 27 children admitted only to the general paediatric ward; 4/19 (21%) of PICU-discharged children developed PTSD (compared with none of 27 ward admissions), p=0.02. PICU children had significantly more PTSD features of irritability and persistent avoidance of reminders of the admission. Parents of PICU children were more likely to screen positive for PTSD (9/33 (27%) compared with 2/29 (7%) parents of ward-admitted children), p=0.04. There were no significant differences between the groups for other measures of psychopathology.

Conclusion

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.
Literature
1.
Stuber ML, Meeske K, Gonzales S, Houskamp BM, Pynoos R (1994) Post-traumatic stress after childhood cancer 1. The role of appraisal. Psycho-Oncology 3:305–312
2.
Butler RW, Rizzi LP, Handwerger BA (1996) Brief report: the assessment of posttraumatic stress disorder in paediatric cancer patients and survivors. J Pediatr Psychol 21:499–504PubMed
3.
Shalev A, Schreiber S, Galai T, Melmed RN (1993) Post-traumatic stress disorder following medical events. Br J Clin Psychol 32:247–253PubMed
4.
Landolt MA, Boehler U, Schwager C, Schallberger U, Nuessli R (1998) Post-traumatic stress disorder in paediatric patients and their parents: an exploratory study. J Paediatr Child Health 34:539–543PubMed
5.
Gledhill J, Garralda ME (2000) The relationship between physical and mental health in children and adolescents. In: Gelder MG, Lopez-Ibor JJ, Andreasen NC Andreasen (eds) New Oxford textbook of psychiatry. Oxford University Press, Oxford, pp 1834–1843
6.
Walker AM, Harris G, Baker A, Kelly D, Houghton J (1999) Post-traumatic stress responses following liver transplantation in older children. J Child Psychol Psychiatry 40 (3):363–374CrossRefPubMed
7.
Lloyd GG (1993) Psychological problems and the intensive care unit. BMJ 307:458–459PubMed
8.
Jones SM, Fiser DH, Livingston RL (1992) Behavioural changes in paediatric intensive care units. Am J Dis Child 146:375–379PubMed
9.
Gemke RJBJ, Bonsel GJ, Van Vught AJ (1995) Long term survival and state of health after paediatric intensive care. Arch Dis Child 73:196–201PubMed
10.
Judge D, Nadel S, Vergnaud S, Garralda ME (2002) Psychiatric adjustment following meningococcal disease treated on a PICU. Intensive Care Med 28:648–650CrossRef
11.
Nader KO, Kriegler JA, Blake DD, Pynoos RS (1994) Clinician administered PTSD scale for children (CAPS-C). National Centre for PTSD, Boston, MA
12.
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn (DSM-IV). American Psychiatric Association, Washington DC
13.
Horowitz M, Wilner N, Alvarez W (1979) Impact of Event Scale: a measure of subjective stress. Psychosom Med 41:209–218PubMed
14.
Yule W, Udwin O (1991) Screening child survivors for post-traumatic stress disorders: Experiences from the “Jupiter” sinking. Br J Clin Psychol 30:131–138PubMed
15.
Perrin S, Smith P, Yule W (2000) Practitioner review: the assessment and treatment of post-traumatic stress disorder in children and adolescents. J Child Psychol Psychiatry 41(3):277–289CrossRefPubMed
16.
Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–585PubMed
17.
Birleson P (1981) The validity of depressive disorder in childhood and the development of a self-rating scale: a research report. J Child Psychol Psychiatry 22:73–88PubMed
18.
Reynolds CR, Richmond BO (1978) What I think and feel: a revised measure of children’s manifest anxiety. J Abnorm Child Psychol 6:271–280PubMed
19.
Garber J, Walker L, Zeman J (1991) Somatization symptoms in a community sample of children and adolescents: further validation of the Children’s Somatization Inventory. J Consult Clin Psychol 3:588–595
20.
Neal LA, Busuttil W, Rollins J, Herepath R, Strike P, Turnbull G (1994) Convergent validity of measures of post-traumatic stress disorder in a mixed military and civilian population. J Trauma Stress 7(3):447–455PubMed
21.
Goldberg D (1972) The detection of psychiatric illness by questionnaire. Oxford University Press, Oxford
22.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–569
23.
Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370PubMed
24.
Stallard P, Velleman R, Baldwin S (1998) Prospective study of post-traumatic stress disorder in children involved in road traffic accidents. BMJ 317:1619–1623PubMed
25.
Keppel-Benson J, Ollendick T, Benson M (2002) Post-traumatic stress in children following motor vehicle accidents. J Child Psychol Psychiatry 43(2):203–212CrossRefPubMed
26.
Playfor S, Thomas D, Choonara I (2000) Recollection of children following intensive care. Arch Dis Child 83(5):445–448CrossRefPubMed
27.
Rundshagen I, Schnabel K, Wegner C, Schulte am Esch J (2002) Incidence of recall, nightmares and hallucinations during analgosedation in intensive care. Intensive Care Med 28:38–43CrossRefPubMed
28.
Malmquist C (1986) Children who witness parental murder: posttraumatic aspects. J Am Acad Child Psychiatry 25(3):320–325
29.
Shears D, Garralda ME, Nadel S, Gledhill J (2002) Psychological outcome of children admitted to hospital with meningococcal disease. Arch Dis Child 86 (suppl 1):A26CrossRef
30.
Perry S, Difede J, Musngi M, Frances AJ, Jacobsberg L (1992) Predictors of post traumatic stress disorder after burn injury. Am J Psychiatry 149:931–935PubMed
31.
Bent KN, Keeling A, Rouston J (1996) Home from the PICU: are parents ready? Am J Matern Child Nurs 21(2):80–84
Metadata
Title
Psychiatric outcome following paediatric intensive care unit (PICU) admission: a cohort study
Authors
Gwyneth Rees
Julia Gledhill
M. Elena Garralda
Simon Nadel
Publication date
01-08-2004
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 8/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-004-2310-9

Other articles of this Issue 8/2004

Intensive Care Medicine 8/2004 Go to the issue

News

New regulations for the care of the critically ill patients in Italy

Correspondence

Reply to Dr. De Waele

Original

Variation of infected cell count in bronchoalveolar lavage and timing of ventilator-associated pneumonia

Correspondence

Cervical spinal epidural abscess and meningitis due to Prevotella oris and Peptostreptococcus micros after retropharyngeal surgery

Experimental

Calpain I inhibitor ameliorates the indices of disease severity in a murine model of cerulein-induced acute pancreatitis

Brief Report

Hyperglycaemia and mortality in critically ill patients