Systematic Review of Interventions to Reduce Psychiatric Morbidity in Parents and Children After PICU Admissions

Objective: To describe and evaluate interventions aimed at reducing psychiatric morbidity in parents and children discharged from PICU. Data Sources: A systematic review of the literature was undertaken, searching EMBASE, PSYCHinfo, MEDLINE, and CINAHL. Experts in the field were contacted to identify unpublished studies. Study Selection: Exclusion criteria: Studies with participants above age 18 or drawn from a neonatal ICU, studies not in English, and those not measuring psychopathology. Data Extraction: Seven hundred fifty-three articles initially identified were hand searched which identified three studies, with a further three studies found by contacting experts in the field. Of these, three were randomized controlled trials and three feasibility studies. Data Synthesis: The interventions primarily targeted parents (particularly mothers), with the aim of reducing psychopathology especially posttraumatic stress disorder. Findings from these few studies demonstrated that interventions can lead to a reduction in parent and child psychopathology. Key ingredients of these interventions included psychoeducation, parent support after discharge, offering intervention to those families at high risk of developing psychopathology as identified by screening at the point of discharge, follow-up of all families with the aim of case finding, and specific interventions to target posttraumatic stress disorder symptoms. Conclusions: Intervention studies are few but do lead to reductions in parent and child psychopathology. There is sufficient information to suggest some of these interventions could be supported and further evaluated.