Psychological Outcomes in Children Following Pediatric Intensive Care Unit Hospitalization

Abstract Background Critically ill children may be at risk for developing negative psychological sequel following pediatric intensive care unit (PICU) hospitalization. The highly invasive technological interventions, lack of control over events, the severity of the child’s illness, and high levels of parental distress have been identified as particularly salient factors Aim of the Work To assess the psychological impact of admission to PICU among children and their parents Methods In this cross-sectional study, 100 children admitted to the PICU or ward and their parents completed the Strength and Difficulties Questionnaire (SDQ) and Hospital Anxiety and Depression Scale (HADS) at admission, 6 weeks, and 6 months after discharge. Results The PICU group (n = 50) had significantly higher disease severity scores than the ward group (n = 50) based on mean PRISM (9.5 vs 3.0, p < 0.001) and mean TISS scores (14.98 vs 6.7, p < 0.001). PICU children had a longer mean length of stay (9.8 vs 4.6 days, p < 0.001). At 6 weeks, 38% of PICU children scored in the high or very high risk range on the SDQ total difficulties score compared to 8% of ward children. At 6 months, 28% of PICU children remained at high or very high risk versus 4% of ward children. The SDQ emotional symptoms subscale was most affected. Regarding parental stress, at 6 weeks 12% of PICU parents had abnormal depression scores on the HADS versus 2% of ward parents, while 14% of PICU parents had abnormal anxiety scores versus 4% of ward parents. Multivariate regression found number of previous admissions, severity scores, and invasive procedures predicted SDQ scores at follow-up. Conclusion PICU admission has a significant psychological impact on children and parents lasting at least 6 months. Screening for those at high risk is recommended.