# Discharge Screening Predicts Persistent Parental Psychological Distress After Pediatric Critical Illness

## TL;DR

Many parents experience lasting psychological distress after their child's critical illness, and screening at hospital discharge can help identify those at highest risk.

## Contribution

This study demonstrates that discharge screening for parental anxiety and depression can predict persistent psychological symptoms weeks later.

## Key findings

- 50% of parents screened positive for anxiety or depression before PICU discharge.
- 44% of parents showed ongoing anxiety, depression, or post-traumatic stress symptoms 30 days later.
- A positive discharge screen was the strongest predictor of long-term psychological distress.

## Abstract

What are the main findings?
Parental psychological distress is common and persistent: Many parents experienced anxiety and depression prior to PICU discharge, and 44% continued to screen positive for anxiety, depression, or post-traumatic stress symptoms more than 30 days after returning home.Discharge screening has predictive value: A positive screen for anxiety or depression at discharge independently predicted ongoing psychological symptoms at 30–60-day follow-up, suggesting a feasible and actionable strategy for identifying families at highest risk.

Parental psychological distress is common and persistent: Many parents experienced anxiety and depression prior to PICU discharge, and 44% continued to screen positive for anxiety, depression, or post-traumatic stress symptoms more than 30 days after returning home.

Discharge screening has predictive value: A positive screen for anxiety or depression at discharge independently predicted ongoing psychological symptoms at 30–60-day follow-up, suggesting a feasible and actionable strategy for identifying families at highest risk.

What is the implication of the main finding?
Opportunities for intervention: Preventing long-term distress may be possible by supporting parents during their child’s ICU stay and using discharge screening to guide targeted follow-up psychosocial interventions.

Opportunities for intervention: Preventing long-term distress may be possible by supporting parents during their child’s ICU stay and using discharge screening to guide targeted follow-up psychosocial interventions.

Background/Objectives: Pediatric critical illness constitutes a highly stressful event not only for the critically ill child but also for the broader family unit. Recognizing and addressing these family-level effects is essential to optimizing outcomes for PICU survivors. Methods: This prospective observational cohort study examined anxiety and depression in parents of pediatric ICU patients prior to PICU discharge using the Hospital Anxiety and Depression (HADS) scale, and again after 30 days. At follow-up, parents were also screened for post-traumatic stress symptoms (PTSS) using the Impact of Events (IES) scale. Parent demographics and characteristics of the child’s hospitalization were collected. Results: 235 parents enrolled and completed a HADS; 126 parents (54%) subsequently completed a follow-up HADS and IES. 50% of parents screened positive for anxiety and/or depression prior to discharge; 44% of parents demonstrated anxiety, depression, and/or PTSS on follow-up screening. A positive HADS prior to discharge was the only independent predictor of persistent psychological symptoms. Conclusions: Parental psychological distress is both common and persistent following a child’s PICU admission. Screening at discharge is a feasible method to identify families at the highest risk for enduring anxiety, depression, and post-traumatic stress symptoms.