Stress hormones and posttraumatic stress symptoms following paediatric critical illness: an exploratory study.

TitleStress hormones and posttraumatic stress symptoms following paediatric critical illness: an exploratory study.
Publication TypeJournal Article
Year of Publication2017
AuthorsAls LC, Picouto MD, O'Donnell K, Nadel S, Cooper M, Pierce CM, Kramer T, Glover VAS, M Garralda E
JournalEur Child Adolesc Psychiatry
Volume26
Issue5
Pagination511-519
Date Published2017 May
ISSN1435-165X
KeywordsAdolescent, Case-Control Studies, Child, Child, Preschool, Circadian Rhythm, Critical Illness, Female, Follow-Up Studies, Hospitalization, Humans, Hydrocortisone, Intensive Care Units, Pediatric, London, Male, Multivariate Analysis, Psychiatric Status Rating Scales, Saliva, Stress Disorders, Post-Traumatic, Time Factors
Abstract

In this exploratory case-control study, we investigated basal cortisol regulation in 5-16-year-old children, 3-6 months following PICU (paediatric intensive care) admission. This was nested within a study of child psychological and cognitive function; 47 children were assessed alongside 56 healthy controls. Saliva samples were collected three times per day (immediately after waking, waking +30 min, and waking +12 h) over two consecutive weekdays. In addition, data on posttraumatic stress symptoms were ascertained from 33 PICU admitted children using the Impact of Events Scale-8 (IES-8). Primary analysis revealed no significant differences in basal cortisol concentrations between PICU discharged children and healthy controls (p > 0.05). Secondary analysis in the PICU group identified a significant positive association between posttraumatic stress symptoms and evening (waking +12 h) cortisol concentrations (p = 0.004). However, when subject to multivariate analysis, evening cortisol was a modest independent predictor of IES-8 scores, relative to the presence of septic illness and poor pre-morbid health. We conclude that paediatric critical illness does not appear to result in marked perturbations to basal cortisol at 3-6 month following discharge. There was evidence of a link between evening cortisol and symptoms of PTSD, but this was not a robust effect and requires further elucidation.

DOI10.1007/s00787-016-0933-3
Alternate JournalEur Child Adolesc Psychiatry
PubMed ID27995329
PubMed Central IDPMC5394132

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