Psychiatric adjustment in the year after meningococcal disease in childhood.
OBJECTIVE
To assess psychiatric status after meningococcal disease.


METHODS
Cohort study of 66 children (34 boys, 32 girls) ages 4 to 17 years admitted to pediatric hospitals with meningococcal disease. The main outcome measure was psychiatric disorder (1-year period and point prevalence on the Schedule for Affective Disorders and Schizophrenia for School-Age Children interview for children 6 years or older; point prevalence in younger children on the Behavior Screening Questionnaire).


RESULTS
During the course of the year after discharge from hospital, psychiatric disorders were identified in 23 of 40 (57%) children ages 6 years or older. The most common primary disorders were depressive, oppositional defiant, and anxiety disorders. At the time of 12-month follow-up, psychiatric disorders were present in 13 of 40 (32%) of those ages 6 or older and in 7 of 26 (26%) under 6 years old. Two children had a diagnosis of posttraumatic stress disorder. Logistic regression analysis showed that global meningococcal illness severity score, clinical shock on admission, and impairing premorbid emotional and behavioral problems in the child were independent predictors of psychiatric disorder at 12-month follow-up.


CONCLUSIONS
Psychiatric disorders are common in the year after meningococcal disease. Especially at risk are children who are severely medically ill and those with more impairing premorbid emotional and behavioral problems.
Shears
Daniel
D
Drs. Shears, Gledhill, and Garralda are with the Imperial College London, Academic Unit of Child and Adolescent Psychiatry; Dr. Nadel is with the St. Mary's Hospital, London; and Dr. Gordon is with the Imperial College London, Statistical Advisory Service.
Nadel
Simon
S
Drs. Shears, Gledhill, and Garralda are with the Imperial College London, Academic Unit of Child and Adolescent Psychiatry; Dr. Nadel is with the St. Mary's Hospital, London; and Dr. Gordon is with the Imperial College London, Statistical Advisory Service.
Gledhill
Julia
J
Drs. Shears, Gledhill, and Garralda are with the Imperial College London, Academic Unit of Child and Adolescent Psychiatry; Dr. Nadel is with the St. Mary's Hospital, London; and Dr. Gordon is with the Imperial College London, Statistical Advisory Service.
Gordon
Fabiana
F
Drs. Shears, Gledhill, and Garralda are with the Imperial College London, Academic Unit of Child and Adolescent Psychiatry; Dr. Nadel is with the St. Mary's Hospital, London; and Dr. Gordon is with the Imperial College London, Statistical Advisory Service.
Garralda
M Elena
ME
Drs. Shears, Gledhill, and Garralda are with the Imperial College London, Academic Unit of Child and Adolescent Psychiatry; Dr. Nadel is with the St. Mary's Hospital, London; and Dr. Gordon is with the Imperial College London, Statistical Advisory Service.. Electronic address: e.garralda@imperial.ac.uk.
D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology*; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011584:Psychology; D011795:Surveys and Questionnaires; D013997:Time Factors