Screening for factors influencing parental psychological vulnerability during a child’s PICU admission

OBJECTIVES: To identify the risks of developing post-traumatic stress disorder (PTSD) and/or depression in parents following their child’s PICU admission using a brief screening instrument and to examine the associations with these risks. 

DESIGN: A cross-sectional parental survey. 

SETTING: A general 13-bed PICU at a large teaching hospital. 

SUBJECTS: One hundred and seven parents of 75 children admitted to the PICU. 
 
INTERVENTIONS: None. 

MEASUREMENTS AND MAIN RESULTS: All parents completed the 10-item Posttraumatic Adjustment Screen (PAS) before discharge. The PAS assesses risk factors known to be associated with poorer psychological outcome, including psychosocial variables pretrauma and peritrauma, and acute stress. Parents’ scores on the PAS indicated that 64 (60%) were at risk of developing PTSD and 80 (75%) were at risk of developing depression following their child’s admission. Univariate analyses suggested that psychosocial variables, such as preexisting stressors and a history of previous mental health problems, were more strongly associated with PAS risk scores for PTSD and depression than medical or sociodemographic factors. In logistic regression analyses, a history of previous mental health problems was significantly associated with risk of developing PTSD and depression (p < 0.001) explaining 28% and 43% of the variance in these outcomes. 

CONCLUSIONS: This study suggests that a significant number of parents on PICU are potentially at risk of developing PTSD and/or depression postdischarge and that psychosocial factors, pretrauma and peritrauma, are stronger determinants of this risk, and of acute distress, than other variables. Identification of vulnerable parents during admission, using a measure such as the PAS, could facilitate the targeting of support and monitoring, acutely and postdischarge, at those who might be most likely to benefit.