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Short report
Post-traumatic stress after PICU and corticosteroid use
  1. Georgina Corbet Burcher1,
  2. Maria D Picouto2,
  3. Lorraine C Als1,
  4. Mehrengise Cooper3,
  5. Christine M Pierce4,
  6. Simon Nadel3,
  7. M Elena Garralda1
  1. 1Centre for Psychiatry, Department of Medicine, Imperial College London, London, UK
  2. 2Coslada Mental Health Service, Department of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain
  3. 3Department of Paediatric Intensive Care, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
  4. 4Department of Paediatric Intensive Care, Great Ormond Street Hospital For Children NHS Trust, London, UK
  1. Correspondence to Dr Georgina Corbet Burcher, Centre for Psychiatry, Imperial College London, London W12 0NN, UK; georgina.corbetburcher{at}nhs.net

Abstract

Aim To examine the association between corticosteroid use in paediatric intensive care units (PICU) and subsequent symptoms of post-traumatic stress disorder (PTSD).

Methods The subjects were children aged 8–16 years admitted to PICU with sepsis, meningoencephalitis (ME) and other disorders. Illness information was extracted from case notes; 3–6 months post discharge children completed a PTSD symptom questionnaire (eight-item Impact of Events Scale (IES-8)) assessing intrusion and avoidance symptoms. Saliva samples were also collected for cortisol profile analysis.

Results 53 children completed the IES-8 questionnaires. 33 provided saliva samples. 19 (36%) received corticosteroids. In children with sepsis (n=15), corticosteroid use was associated with significantly lower PTSD intrusion symptom scores. There was a trend towards an association between corticosteroid use and lower evening cortisol levels. There was a comparable but weaker trend in children with ME.

Discussion Corticosteroid use may be associated with fewer PTSD symptoms and lower evening cortisol levels following PICU admission in children with sepsis.

  • post-traumatic stress disorder
  • corticosteroids
  • paediatric intensive care
  • child
  • ptsd

http://dx.doi.org/10.1136/archdischild-2017-314157

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    Footnotes

    • Contributors GCB analysed the data and wrote the manuscript. MDP and LCA collected and analysed the data. SN, MC and CMP supervised the study. MEG supervised the study and wrote the manuscript. All authors reviewed and approved the final manuscript.

    • Funding The grant support for this study was provided by the Meningitis Research Foundation of the UK. The funder had no role in the study design, execution, analysis or manuscript preparation. GCB was funded by the National Institute for Health Research. MDP was supported by the Alicia Koplowitz Foundation. The research was undertaken at Imperial College Academic Health Science Centre and Great Ormond Street Hospital for Children NHS Trust, both of which are supported by the National Institute for Health Research Biomedical Research Centres funding scheme.

    • Competing interests None declared.

    • Ethics approval Hammersmith Hospital Research Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The data from the current study are available from the authors on request.