Psychological Outcomes in Families of PICU Survivors: A Meta-Analysis.

Abstract

Pediatric critical illness exposes family members to stressful experiences that may lead to subsequent psychological repercussions. To systematically review psychological outcomes among PICU survivors' family members. Four medical databases (PubMed, Embase, CINAHL and PsycInfo) were searched from inception till October 2023. Studies reporting psychological disorders in family members of PICU patients with at least 3 months follow-up were included. Family members of nonsurvivors and palliative care patients were excluded. Screening and data extraction was performed according to PRISMA guidelines. Data were pooled using a random-effects model. Of 5360 articles identified, 4 randomized controlled trials, 16 cohort studies, and 2 cross-sectional studies were included (total patients = 55 597; total family members = 97 506). Psychological distress was reported in 35.2% to 64.3% and 40.9% to 53% of family members 3 to 6 months and 1 year after their child's PICU admission, respectively. Post-traumatic stress disorder was diagnosed in 10% to 48% of parents 3 to 9 months later. Parents that experienced moderate to severe anxiety and depression 3 to 6 months later was 20.9% to 42% and 6.1% to 42.6%, respectively. Uptake of mental counseling among parents was disproportionately low at 0.7% to 29%. Risk factors for psychiatric morbidity include mothers, parents of younger children, and longer duration of PICU stay. The majority of studies were on parents with limited data on siblings and second degree relatives. There is a high burden of psychological sequelae in family members of PICU survivors. Risk stratification to identify high-risk groups and early interventions are needed.