Posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment compared to children who survived a major fire disaster

Madelon B Bronner,Bob F Last,Hendrika Knoester,Martha A Grootenhuis,Albert P Bos

doi:10.1186/1753-2000-2-9

Abstract

BackgroundThe goals were to determine the presence of posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment, to identify risk factors for PTSD, and to compare this data with data from a major fire disaster in the Netherlands.MethodsChildren completed the Dutch Children's Responses to Trauma Inventory at three and nine months after discharge from the paediatric intensive care unit (PICU). Comparison data were available from 355 children survivors who completed the same questionnaire 10 months after a major fire disaster.ResultsThirty-six children aged eight to 17 years completed questionnaires at three month follow-up, nine month follow-up, or both. More than one third (34.5%) of the children had subclinical PTSD, while 13.8% were likely to meet criteria for PTSD. Maternal PTSD was the strongest predictor for child PTSD. There were no significant differences in (subclinical) PTSD symptoms either over time or compared to symptoms of survivors from the fire disaster.ConclusionThis study shows that a considerable number of children have persistent PTSD after PICU treatment. Prevention of PTSD is important to minimize the profound adverse effects that PTSD can have on children's well-being and future development.

Highlights

The goals were to determine the presence of posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment, to identify risk factors for PTSD, and to compare this data with data from a major fire disaster in the Netherlands
Posttraumatic stress disorder (PTSD) is characterized by [1] persistent reliving or remembering of the stressful event in vivid memories, repetitive play, and nightmares; [2] avoidance of thoughts or places associated with the stressful event; [3] symptoms of increased arousal, such as sleeping and concentration problems accompanied by physical symptoms and/or [4] new fears, aggressive behaviour and loss of previously acquired developmental skills
Prevalence and course of PTSD PTSD data were available for 36 children; 21 completed questionnaires at three and nine months follow-ups; eight only completed questionnaires at the three month followup; seven only completed questionnaires at the nine month follow-up

Summary

Introduction

The goals were to determine the presence of posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment, to identify risk factors for PTSD, and to compare this data with data from a major fire disaster in the Netherlands. The list of potential stressful events leading to PTSD during childhood has increased [5]. In 1994, both injury and being diagnosed with a life-threatening illness were listed as potential stressful events [6,7]. This resulted in an increasing number of studies examining the prevalence and risk factors of PTSD in paediatrics, predominantly in paediatric oncology and trauma patients [7,8]. The reported prevalence of PTSD varies between 5% and 35% depending on the population studied [9,10,11]

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