title: Short-term psychiatric adjustment of children and their parents following meningococcal disease.
abstract: OBJECTIVE
  To assess short-term changes in child and parent psychiatric status following meningococcal disease.
  
  
  METHODS
  Prospective cohort study; 3-month follow-up using parent, teacher, and child questionnaires.
  
  
  METHODS
  Hospital admissions to three pediatric intensive care units and 19 general pediatric wards.
  
  
  METHODS
  Sixty children aged 3-6 yrs, 60 mothers, and 45 fathers.
  
  
  METHODS
  We administered measures of illness severity (Glasgow Meningococcal Septicaemia Prognostic Score, days in hospital) and psychiatric morbidity (Strengths and Difficulties Questionnaires, parent and teacher versions; Impact of Event scales; General Health Questionnaire-28).
  
  
  RESULTS
  In children admitted to pediatric intensive care units, parental reports at 3-month follow-up showed a significant increase in emotional and hyperactivity symptoms and in related impairment; symptoms of posttraumatic stress disorder were present in four of 26 (15%) children >8 yrs old. Regarding the parents, 26 of 60 (43%) mothers in the total sample had questionnaire scores indicative of high risk for psychiatric disorder and 22 of 58 (48%) for posttraumatic stress disorder. In fathers there was high risk for psychiatric disorder in 11 of 45 (24%) and for posttraumatic stress disorder in 8 of 43 (19%). Severity of the child's physical condition on admission was significantly associated with hyperactivity and conduct symptoms at follow-up. Length of hospital admission was associated with psychiatric symptoms in the child and posttraumatic stress disorder symptoms in parents. There were also significant associations between psychiatric symptoms in children and parents.
  
  
  CONCLUSIONS
  Admission of children to pediatric intensive care units for meningococcal disease is associated with an increase in and high levels of psychiatric and posttraumatic stress disorder symptoms in children and parents. Length of admission is associated with psychiatric symptoms in children and posttraumatic stress disorder symptoms in parents. Pediatric follow-up should explore psychiatric as well as physical sequelae in children and parents.
authors.affiliation: The Academic Unit of Child and Adolescent Psychiatry, Imperial College London (St. Mary's Campus), Norfolk Place, London. d.shears@imperial.ac.uk
authors.forename: Daniel
authors.initials: D
authors.lastname: Shears
authors.forename: Simon
authors.initials: S
authors.lastname: Nadel
authors.forename: Julia
authors.initials: J
authors.lastname: Gledhill
authors.forename: M Elena
authors.initials: ME
authors.lastname: Garralda
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000298:Adolescent, Hospitalized / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000209:etiology; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008131:London / Q000453:epidemiology; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000209:etiology / Q000523:psychology; D018434:Sickness Impact Profile; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors