Psychological and Psychiatric Outcomes Following PICU Admission: A Systematic Review of Cohort Studies

Objective: Admissions to PICU places pediatric patients at increased risk of persistent psychological and psychiatric morbidity. This systematic review aimed to summarize and critically examine literature regarding psychological and psychiatric outcomes of pediatric patients following PICU admission. Data Sources: MEDLINE, Web of Science, Cochrane Library, Science Direct, PsycInfo, CINAHL, LILACS, and SciELO were searched up to May 2016. Study Selection: Cohort studies about psychological and psychiatric outcomes of pediatric patients following PICU admission; full-text records published in English, Spanish, or Portuguese in peer-reviewed journals from 2000 to 2015 were included. Neonatal patient population (age, <1 mo), follow-up after PICU discharge (<3 mo), and nonprimary literature were excluded. Two reviewers independently screened studies based on the predetermined exclusion criteria. Data Extraction: Data were extracted using an adapted tool. The internal validity and risk of bias were assessed using Newcastle-Ottawa Scale. Data Synthesis: The search yielded 1,825 studies after the removal of duplications, of which eight met the inclusion criteria. Methodologic quality of the studies ranged from low to high, with an average score of five of nine. Of all the studies, half had a control group. Regarding the length of follow-up, most of the studies ranged from 3 to 12 months. Conclusions: Psychological and psychiatric outcomes after pediatric critical illness appear to be substantial issues that need to be further studied. Our review highlights the need for psychological screening of pediatric patients and their parents following PICU admission since these patients are a vulnerable population at risk for developing psychiatric responses.