Parental Symptoms of Anxiety and Depression Upon PICU Discharge and at 30-Day Follow-Up
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Administration, Behavioral Health and Well Being, 2022
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INTRODUCTION: As PICU mortality rates decreased over the last two decades, attention turned to improving long-term post-PICU morbidity. Research shows that a PICU stay affects not just the child-survivor, but also the larger family unit, with effects most pronounced on parents. We hypothesized that many parents would already exhibit symptoms of anxiety/depression prior to PICU discharge, and this would predict future mental health symptoms. METHODS: This prospective observational study enrolled parents of PICU survivors. Each parent completed the Hospital Anxiety and Depression Scale (HADS) as a screen for symptoms of anxiety and depression within 48-hours prior to the child’s discharge. At 30+day follow-up, parents completed an additional HADS, as well as an Impact of Events Scale (IES) to screen for symptoms of post-traumatic stress disorder (PTSD). Demographic data were collected from parents and clinical data extracted from the child’s medical record. Chi-square/Fisher’s exact tests were used to describe bivariate associations between predictors of interest and a positive psychological screen; all variables that achieved p < 0.1 were built into a multivariable model. Primary outcome was a positive screen for either anxiety, depression, or PTSD more than 30-days after PICU stay. RESULTS: 126 parents enrolled and completed both assessments. 50% screened positive for anxiety and/or depression upon discharge; this was independently associated with higher education (aOR 2.6, p=0.046 for parents with college degrees), and with a pre-PICU diagnosis of a mental health disorder (aOR 4.4, p=0.035). At follow-up, 56 parents (44%) screened positive for anxiety, depression, and/or PTSD symptoms (32% anxiety, 13% depression, 27% PTSD). In multivariable analysis, the only independent predictor of mental health symptoms more than 30 days after PICU stay was a positive HADS prior to PICU discharge (aOR 5.9, p < 0.001). CONCLUSIONS: This pilot study demonstrates that screening for anxiety and depression at PICU discharge may be a way to identify parents at higher risk for longer-term psychiatric symptoms. By targeting at-risk parents, future interventional studies can be designed to test the effectiveness of early intervention programs at decreasing the burden of post-intensive care syndrome on families after PICU stay.
Meta Tag
Content Type Presentation
Knowledge Area Administration
Knowledge Area Behavioral Health and Well Being
Knowledge Level Intermediate
Knowledge Level Advanced
Membership Level Select
Tag Patient and Family Support
Tag Pediatric Intensive Care Unit PICU
Tag Depression
Year 2022
pediatric ICU
mental health


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