During the past decade, an increasing number of children have been admitted to pediatric intensive care units (PICUs). Most survive and experience good physical recovery. Yet a growing body of research suggests children admitted to a PICU may suffer negative long-term psychological outcomes. Researchers conducted a systematic review and meta-analysis to synthesize the literature describing long-term psychological problems among children admitted to the PICU using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria.

The analysis included 31 independent studies of children younger than 18 years of age who were previously admitted to the PICU and had a follow-up of at least three months. The mean age of the 7,786 participants was 7.3 years and 4,267 (54.8%) were male. Children admitted for primary brain conditions and those discharged home for palliative care were excluded.

Overall, one of 19 children (5.3%) to 14 of 16 children (88%) had at least one psychological disorder, ranging from three months to 15 years after PICU admission. Compared with healthy children, those previously admitted to the PICU had greater emotional and behavioral problems at four years of follow-up and lower IQ scores at one to two years and three to five years of follow-up. Overall, six of 60 children (10%) admitted to the PICU had posttraumatic stress disorder at three to six months of follow-up, and 35 of 272 children (12.9%) met the criteria at six to 12 months of follow-up. Memory impairment, attention deficit, developmental delay, and depression were also observed, and many of these problems persisted for years.

The authors advise that beyond improving the physical health of children admitted to the PICU, health care providers may need to consider the psychological sequelae that can result from a child's illness and PICU experience and make efforts to identify those in the PICU who are at high risk for psychological morbidity.

Certain PICU populations were underrepresented in the studies included in the analysis, and there was a lack of studies examining the association between indications for PICU admission and psychological outcomes. Also, variations in the studies' methodologies made pooling results difficult.