Department of Pediatric Intensive Care, University Hospital of Angers, Angers, France.
Department of Child and Adolescent Psychiatry, University Hospital of Angers, Angers, France.
Eur Child Adolesc Psychiatry. 2024 Sep;33(9):2991-3001. doi: 10.1007/s00787-023-02141-8. Epub 2023 Feb 5.
The number of studies on post-traumatic stress disorder after hospitalization in a pediatric intensive care unit raised since 2004. The objective of this systematic review was to summarize and critically examine the literature about risk factors for these children to develop post-traumatic stress disorder following admission to an intensive care unit. The data sources were PubMed, Cochrane, Web of Science, PsycInfo, SUDOC, Scopus, and ScienceDirect. Studies were selected if they were in English or French and published between 01/01/2004 and 31/01/2022. Studies were excluded if patients were less than 1 month old and if no post-traumatic stress disorder was found. The internal validity and risk of bias were assessed using the National Institutes of Health Study Quality Assessment Tools for observational studies and the Ottawa Scale was used for the interventional study. The search yielded 523 results and 22 articles met inclusion criteria. Three common risk factors were identified from the data: parental post-traumatic stress disorder (especially in mothers), severity of illness and delusional memories. Internalizing behavior in children, acute parent and child stress, emergency admission and sepsis are also potential risk factors that require further investigation. The prevalence of this pathology is substantial (between 14 and 36%) and increasing awareness among pediatricians and psychologists seems necessary. Prevention programs are being studied to reduce the incidence of post-traumatic stress disorder in this population. Child and adolescent psychiatry liaison should collaborate with pediatric teams to support this objective.
自 2004 年以来，有关儿科重症监护病房（PICU）后创伤后应激障碍（PTSD）的研究数量有所增加。本系统综述的目的是总结和批判性地检查有关这些儿童在入住重症监护病房后发生 PTSD 的危险因素的文献。数据来源包括 PubMed、Cochrane、Web of Science、PsycInfo、SUDOC、Scopus 和 ScienceDirect。如果研究为英文或法文，且发表于 2004 年 1 月 1 日至 2022 年 1 月 31 日之间，则将其纳入研究。如果患者年龄小于 1 个月或未发现 PTSD，则将其排除在外。使用 NIH 观察性研究质量评估工具评估内部有效性和偏倚风险，使用渥太华量表评估干预性研究。检索结果产生了 523 项结果，其中 22 项文章符合纳入标准。从数据中确定了三个常见的危险因素：父母的 PTSD（尤其是母亲）、疾病严重程度和妄想记忆。儿童的内化行为、父母和儿童的急性应激、紧急入院和败血症也是需要进一步研究的潜在危险因素。这种病理的患病率很高（在 14%至 36%之间），儿科医生和心理学家的意识提高似乎是必要的。正在研究预防计划以降低该人群 PTSD 的发生率。儿童和青少年精神病学联络应与儿科团队合作，以支持这一目标。
