Stress hormones and posttraumatic stress symptoms following paediatric critical illness: an exploratory sudy
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
In t
his exploratory
case
-
control study
we
investigated
basal
cortisol regulation
in
5
-
16 year
-
old children, 3
-
6
months
following
PICU (paediatric intensive care) admi
ssion
.
This
was nested within a study of
child
psych
ological 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 +12h)
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
+12h) cortisol concentrations
(p = 0.004).
Howev
er 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. T
here was evidence
of a link between evening cortisol and symptoms of PTSD,
but
this was not a robust effect
and
requ
ires
further
elucidation.
his exploratory
case
-
control study
we
investigated
basal
cortisol regulation
in
5
-
16 year
-
old children, 3
-
6
months
following
PICU (paediatric intensive care) admi
ssion
.
This
was nested within a study of
child
psych
ological 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 +12h)
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
+12h) cortisol concentrations
(p = 0.004).
Howev
er 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. T
here was evidence
of a link between evening cortisol and symptoms of PTSD,
but
this was not a robust effect
and
requ
ires
further
elucidation.
Date Issued
2016-12-19
Date Acceptance
2016-12-06
Citation
European Child & Adolescent Psychiatry, 2016, 26 (5), pp.511-5119
ISSN
1435-165X
Publisher
Springer Verlag (Germany)
Start Page
511
End Page
5119
Journal / Book Title
European Child & Adolescent Psychiatry
Volume
26
Issue
5
Copyright Statement
© The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Sponsor
Meningitis Research Foundation
Grant Number
MRF
Subjects
Social Sciences
Science & Technology
Life Sciences & Biomedicine
Psychology, Developmental
Pediatrics
Psychiatry
Psychology
Salivary cortisol
Critical illness
Psychological sequelae
Post-traumatic stress disorder
SALIVARY CORTISOL CONCENTRATIONS
INTENSIVE-CARE-UNIT
INDIVIDUAL-DIFFERENCES
ADRENAL INSUFFICIENCY
PTSD SYMPTOMS
CHILDREN
DISORDER
ADMISSION
SEPSIS
SURVIVORS
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
Developmental & Child Psychology
1103 Clinical Sciences
1701 Psychology
Publication Status
Published