In this exploratory case–control study, we investigated basal cortisol regulation in 5–16-year-old children, 3–6 months following PICU (paediatric intensive care) admission. This was nested within a study of child psychological and cognitive function; 47 children were assessed alongside 56 healthy controls. Saliva samples were collected three times per day (immediately after waking, waking +30 min, and waking +12 h) over two consecutive weekdays. In addition, data on posttraumatic stress symptoms were ascertained from 33 PICU admitted children using the Impact of Events Scale-8 (IES-8). Primary analysis revealed no significant differences in basal cortisol concentrations between PICU discharged children and healthy controls (p > 0.05). Secondary analysis in the PICU group identified a significant positive association between posttraumatic stress symptoms and evening (waking +12 h) cortisol concentrations (p = 0.004). However, when subject to multivariate analysis, evening cortisol was a modest independent predictor of IES-8 scores, relative to the presence of septic illness and poor pre-morbid health. We conclude that paediatric critical illness does not appear to result in marked perturbations to basal cortisol at 3–6 month following discharge. There was evidence of a link between evening cortisol and symptoms of PTSD, but this was not a robust effect and requires further elucidation.
CITATION STYLE
Als, L. C., Picouto, M. D., O’Donnell, K. J., Nadel, S., Cooper, M., Pierce, C. M., … Garralda, M. E. (2017, May 1). Stress hormones and posttraumatic stress symptoms following paediatric critical illness: an exploratory study. European Child and Adolescent Psychiatry. Dr. Dietrich Steinkopff Verlag GmbH and Co. KG. https://doi.org/10.1007/s00787-016-0933-3
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