Post-traumatic stress after PICU and corticosteroid use

Area of Science:

• Pediatric critical care medicine
• Neuroscience
• Psychiatry

Background:

• Pediatric intensive care unit (PICU) admission can lead to long-term psychological distress, including post-traumatic stress disorder (PTSD).
• The role of corticosteroid administration during critical illness in mitigating subsequent PTSD symptoms in children remains an area of investigation.

Purpose of the Study:

• To investigate the association between corticosteroid use in the PICU and the development of PTSD symptoms in children.
• To explore the relationship between corticosteroid use, PTSD symptoms, and cortisol levels post-PICU discharge.

Main Methods:

• Children aged 8-16 admitted to the PICU with conditions such as sepsis and meningoencephalitis were included.
• PTSD symptoms were assessed 3-6 months post-discharge using the eight-item Impact of Events Scale (IES-8).
• Salivary cortisol profiles were analyzed to assess physiological stress responses.

Main Results:

• Corticosteroid use was significantly associated with lower PTSD intrusion symptom scores in children with sepsis (n=15).
• A trend suggested an association between corticosteroid use and lower evening cortisol levels in children with sepsis.
• Similar but weaker trends were observed in children with meningoencephalitis.

Conclusions:

• Corticosteroid administration in the PICU may be linked to a reduction in PTSD symptoms in children, particularly those with sepsis.
• The findings suggest a potential neuroendocrine protective effect of corticosteroids against PTSD development after critical illness.