Risks of developing major psychiatric disorders among child and adolescent intensive care unit survivors

• Published in: Journal of affective disorders 2024-10, Vol.362, p.772-778
• Main Authors: Wu, Ping-Chung, Tsai, Shih-Jen, Bai, Ya-Mei, Hsu, Ju-Wei, Su, Tung-Ping, Chen, Tzeng-Ji, Chen, Mu-Hong
• Format: Article
• Language: English
• Subjects: Adolescent; Bipolar Disorder - epidemiology; Bipolar Disorder - psychology; Case-Control Studies; Child; Critical illness; Critical Illness - psychology; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Female; Humans; Intensive Care Units - statistics & numerical data; Major psychiatric disorders; Male; Mental Disorders - epidemiology; Mental Disorders - psychology; Obsessive-Compulsive Disorder - epidemiology; Pediatric intensive care unit survivors; Risk Factors; Schizophrenia - epidemiology; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - psychology; Survivors - psychology; Survivors - statistics & numerical data; Taiwan
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2024.07.124

The mental health of child and adolescent intensive care unit (ICU) survivors is increasingly being researched. However, the literature on how various types of critical illness influence specific psychiatric disorders remains limited. This study analyzed the data of 8704 child and adolescent ICU survivors and 87,040 age-, sex-, family income–, and residence-matched controls who were followed from enrollment to the end of 2013; the data covered the period from 1996 to 2013 and were extracted from a nationwide data set. The primary outcomes were the risks of five major psychiatric disorders (MPDs), namely schizophrenia, bipolar disorder (BD), major depressive disorder (MDD), obsessive compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). Relative to the controls, the child and adolescent ICU survivors (mean age = 10.33 years) exhibited higher risks of developing five MPDs. The associated hazard ratios (HRs) and confidence intervals (CIs) are as follows: PTSD, HR = 4.67, 95 % CI = 2.42–9.01; schizophrenia, HR = 3.19, 95 % CI = 2.27–4.47; BD, HR = 2.02, 95 % CI = 1.33–3.05; OCD, HR = 1.96, 95 % CI = 1.21–3.16; and MDD, HR = 1.68, 95 % CI = 1.44–1.95. The risks of developing MPDs varied across multiple types of critical illness related to ICU admission. The risks of MPDs were significantly higher among the child and adolescent ICU survivors than among the controls. The development of appropriate MPD prevention strategies should be emphasized for this vulnerable population. •Child and adolescent ICU survivors had increased risks of schizophrenia, bipolar disorder, major depression and PTSD.•The ICU survivors with an ICU stay of ≥3 days was associated with a significantly higher risk (16-fold) of PTSD.•The development of mental health improvement strategies should be emphasized for child and adolescent ICU survivors.