Stress hormones and posttraumatic stress symptoms following paediatric critical illness: an exploratory study.
|Title||Stress hormones and posttraumatic stress symptoms following paediatric critical illness: an exploratory study.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Als LC, Picouto MD, O'Donnell K, Nadel S, Cooper M, Pierce CM, Kramer T, Glover VAS, M Garralda E|
|Journal||Eur Child Adolesc Psychiatry|
|Date Published||2017 May|
|Keywords||Adolescent, 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|
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.
|Alternate Journal||Eur Child Adolesc Psychiatry|
|PubMed Central ID||PMC5394132|