Meentken Maya G, van Beynum Ingrid M, Legerstee Jeroen S, Helbing Willem A, Utens Elisabeth M W J
Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital , Rotterdam , Netherlands.
Division of Cardiology, Department of Pediatrics, Erasmus MC - Sophia Children's Hospital , Rotterdam , Netherlands.
Front Pediatr. 2017 Feb 13;5:20. doi: 10.3389/fped.2017.00020. eCollection 2017.
Children and adolescents with a congenital heart defect (ConHD) frequently undergo painful or frightening medical procedures and hospitalizations. They often need multiple invasive procedures at a very young age and require regular checkups during their entire life. From other pediatric populations, it is known that these kinds of experiences can result in acute stress reactions and even in post-traumatic stress disorder (PTSD) in the long-term. PTSD and also subthreshold PTSD can lead to serious (psychosocial) impairment. However, limited information is available about PTSD in children with ConHD. Therefore, the aim of this review is to provide a summary of the current literature on post-traumatic stress (PTS) in children and adolescents with ConHD describing the prevalence of PTSD and its predictors/correlates. This review indicates that a range of 12-31% of children undergoing cardiac surgery develop PTSD. A range of 12-14% shows elevated post-traumatic stress symptoms (PTSS). These findings are comparable to those of hospitalized children without ConHD. Noteworthy, most studies used varying self-report questionnaires to measure PTSD and only one study used a semistructured interview. Although all studies point in the same direction of elevated PTSD and PTSS, systematic research is necessary to be able to draw firm conclusions. At present, as far as we know, in most clinics treating patients with ConHD, there is no regular screening for PTS in children with ConHD. In the reviewed literature, there is strong consensus that screening for PTSS and (preventive) psychological care for children and adolescents with ConHD is urgently needed.
患有先天性心脏病（ConHD）的儿童和青少年经常要接受痛苦或令人恐惧的医疗程序和住院治疗。他们在很小的时候就常常需要进行多次侵入性手术，并且一生中都需要定期检查。从其他儿科人群中可知，这类经历可能会导致急性应激反应，甚至长期会引发创伤后应激障碍（PTSD）。PTSD以及亚阈值PTSD会导致严重的（心理社会）损害。然而，关于患有ConHD的儿童的PTSD的信息有限。因此，本综述的目的是总结当前关于患有ConHD的儿童和青少年创伤后应激（PTS）的文献，描述PTSD的患病率及其预测因素/相关因素。本综述表明，接受心脏手术的儿童中有12% - 31%会患上PTSD。有12% - 14%表现出创伤后应激症状（PTSS）升高。这些发现与没有ConHD的住院儿童的发现相当。值得注意的是，大多数研究使用了不同的自我报告问卷来测量PTSD，只有一项研究使用了半结构化访谈。尽管所有研究都指向PTSD和PTSS升高的同一方向，但仍需要系统的研究才能得出确凿的结论。目前，据我们所知，在大多数治疗ConHD患者的诊所中，并没有对患有ConHD的儿童进行PTS的常规筛查。在所综述的文献中，人们强烈一致认为，迫切需要对患有ConHD的儿童和青少年进行PTSS筛查和（预防性）心理护理。
