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Child and Parent Outcomes in the 2018-2019 DEPICT (Differences in Access to Emergency Pediatric Intensive Care and
Emma C Alexander1,2, Anjalika Mallick1, Sarah E Seaton3
1Paediatric Intensive Care Unit, St Mary's Hospital, London, United Kingdom.
Insights
One year after pediatric intensive care unit (PICU) admission, children with comorbidities experienced significantly poorer quality of life. Parents also reported high rates of anxiety, depression, and post-traumatic stress disorder (PTSD).
Area of Science:
- Pediatric critical care medicine
- Child health outcomes
- Parental mental health
Background:
- The DEPICT study previously assessed emergency pediatric intensive care and transport in the UK.
- A 12-month follow-up was conducted to evaluate long-term outcomes.
Purpose of the Study:
- To assess child quality of life and parental mental health (anxiety, depression, PTSD) 12 months after pediatric intensive care unit (PICU) admission.
- To identify factors associated with impaired outcomes.
Main Methods:
- Follow-up questionnaires administered to the DEPICT cohort (n=419) and their parents/caregivers in 2020.
- Assessment of pediatric quality of life (PedsQL), health utilities index (HUI-2), and parental mental health screening.
- Analysis of baseline characteristics, comorbidities, and healthcare utilization.
Main Results:
- Children with baseline comorbidities had significantly worse PedsQL and HUI-2 scores at 12 months compared to previously healthy children.
- Approximately 30.9% of parents screened positive for anxiety, 21.8% for depression, and 28.2% for PTSD.
- Parental mental health issues correlated with poorer child quality of life scores.
Conclusions:
- Children admitted to the PICU may experience persistent quality of life impairments, particularly those with pre-existing conditions.
- High rates of parental anxiety, depression, and PTSD were observed post-PICU admission.
- Further research is needed on child and family support and optimal follow-up care models.
Objective:
The 2018-2019 DEPICT (Differences in Access to Emergency pediatric Intensive Care and care during Transport) study in the United Kingdom had a follow-up questionnaire component, 12 months after PICU admission. We now report the quality of life findings in the children and mental health outcomes (i.e., anxiety, depression, and post-traumatic stress disorder [PTSD]) in the parents.
Design:
DEPICT cohort follow-up study using questionnaires and registered with ClinicalTrials.gov (NCT03520192) in 2017.
Setting:
PICU transport teams and 24 PICUs admitting children transported between January 2018 and January 2019 in United Kingdom.
Patients:
DEPICT cohort ( n = 419, depending on missingness) children and related parents/caregivers with 2020 outcome questionnaires.
Interventions:
None.
Measurements And Main Results:
We evaluated parental proxy-reported questionnaires covering their child's baseline characteristics, pediatric quality of life (PedsQL) and health utilities index (HUI-2), and healthcare utilization; we also assessed parent questionnaires testing for any anxiety, depression, and PTSD. At the time of transfer, 225 of 419 (53.7%) of the children were aged under 1-year; most required transfer for respiratory reasons; and, 194 of 419 (46.3%) had preexisting comorbidities. At 12-month post-PICU admission, around half of the children with a baseline comorbidity had impaired overall PedsQL quality of life scores (57.1%, 105/184), compared with around a quarter of previously healthy children (23.1%, 49/212). Both PedsQL and HUI-2 scores were significantly worse for children with baseline comorbidities. At follow-up, 105 of 340 (30.9%) of parents met screening thresholds for anxiety, 74 of 340 (21.8%) for depression, and 84 of 298 (28.2%) for PTSD. Parent anxiety, depression and PTSD were correlated with poor quality of life scores for their child.
Conclusions:
The 2020, 12-month outcome findings of the 2018-2019 DEPICT study, highlights post-PICU impairments in child quality of life, and high rates of parental mental health issues. Further study of contemporary child and family support, as well as the optimal model for follow-up care, are needed.
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