title: Mental and physical well-being following admission to pediatric intensive care.
abstract: OBJECTIVE
  To assess mental and physical well-being in school-aged children following admission to pediatric intensive care and to examine risk factors for worse outcome.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Two PICUs.
  
  
  METHODS
  A consecutive sample of 88 patients 5-16 years old (median age, 10.00 yr; interquartile range, 6.00-13.00 yr) admitted to PICU from 2007 to 2010 with septic illness, meningoencephalitis, or other critical illnesses were assessed a median of 5 months following discharge and outcomes compared with 100 healthy controls.
  
  
  METHODS
  None.
  
  
  RESULTS
  Parents completed questionnaires documenting child mental and physical well-being, including the Strengths and Difficulties Questionnaires, Chalder Fatigue Scale, and Child Sleep Habits Questionnaire. Children over 8 years completed the Impact of Event Scale -8. The children admitted to PICU scored worse on all measures in comparison with the healthy controls, with 20% scoring at risk for psychiatric disorder, 34% with high levels of post-traumatic stress symptoms, 38% at risk for fatigue disorder, and 80% scoring at risk for sleep disturbance. In the PICU group, multivariable regression analyses identified septic illness as an independent predictor of post-traumatic stress symptoms and family status, past child health problems, and PICU length of stay as predictors of reduced general mental well-being.
  
  
  CONCLUSIONS
  Our findings indicate that a significant minority of school-aged children admitted to PICU are at risk for reduced mental and physical well-being in the short term. Symptoms of poor mental well-being were linked to both vulnerability factors and critical illness factors.
authors.affiliation: 1Centre for Mental Health, Department of Medicine, Imperial College London, London, United Kingdom. 2Department of Child and Adolescent Psychiatry and Psychology, Sant Joan de Déu Hospital, Universitat de Barcelona, Barcelona, Spain. 3Department of Paediatric Intensive Care, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 4Department of Paediatric Intensive Care, Great Ormond Street Hospital, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
authors.forename: Lorraine C
authors.initials: LC
authors.lastname: Als
authors.forename: Maria D
authors.initials: MD
authors.lastname: Picouto
authors.forename: Sau-Ming
authors.initials: SM
authors.lastname: Hau
authors.forename: Simon
authors.initials: S
authors.lastname: Nadel
authors.forename: Mehrengise
authors.initials: M
authors.lastname: Cooper
authors.forename: Christine M
authors.initials: CM
authors.lastname: Pierce
authors.forename: Tami
authors.initials: T
authors.lastname: Kramer
authors.forename: M Elena
authors.initials: ME
authors.lastname: Garralda
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005190:Family / Q000523:psychology; D005260:Female; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008603:Mental Health; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012890:Sleep; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*