Pediatric Medical Traumatic Stress in Inflammatory Bowel Disease, Pancreatitis, and Cystic Fibrosis

Abstract

Objectives: Known as pediatric medical traumatic stress (PMTS), posttraumatic stress symptoms from medical experiences have not been explored in children with chronic gastrointestinal diseases. This cross-sectional study of children and adolescents with inflammatory bowel disease, chronic pancreatitis and cystic fibrosis, aimed to (1) estimate the prevalence of medical potentially traumatic events (PTEs) and PMTS, (2) explore potential risk factors for PMTS, and (3) explore potential consequences of PMTS. Methods: This cross-sectional study used validated, self-report measures to evaluate PTEs and PMTS. Descriptive statistics and regression analyses were used to achieve study objectives. Results: Over two-thirds of children reported a medical potentially traumatic event (91 of 132, 69%). Forty-eight had PMTS symptoms (36%). PMTS was associated with medication burden, emergency and intensive care visits, and parent posttraumatic stress disorder in multivariate analysis. Potential consequences associated with PMTS included school absenteeism, home opioid use, poor quality of life, and parent missed work. Conclusions: A substantial portion of our cohort reported medical PTEs and PMTS. The exploratory analysis identified potential associations between PMTS and illness factors, parent posttraumatic stress disorder, and functional impairments. Further studies of PMTS detection, prevention and treatment are integral to optimizing these children's health and quality of life.

Variability of Psychosocial Services Within the ImproveCareNow Learning Health System: Opportunities for Optimization

“…Recommendations for IBD Centers of Excellence include a multidisciplinary team with specialized psychosocial services (15), which also aligns with calls for an increase in engagement with psychosocial services for pediatric patients with IBD and their families (1–13,16). Data derived from this survey denoted that out of 58 US centers responding, 52 (89.7%) have identifiable available psychosocial services for pediatric patients with IBD.…”

“…Indeed, while the majority of responding ICN care centers had a psychosocial service presence, the current availability of those services remains limited. Psychosocial distress can impact quality of life, disability status, medical outcomes, and utilization of medical services for youth with IBD, and there is a palpable need for psychosocial services, routine patient mental health screenings, and related supports for this at-risk population (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Efforts to bolster advocacy for psychosocial services will likely need to occur through continued collaborations between invested partners including medical providers, system level leaders, researchers, psychosocial providers, and patients and their families.…”

“…Y outh with inflammatory bowel disease (IBD) are known to be at elevated risk to experience depression, anxiety, social difficulties, poorer school functioning, lower health-related quality of life, fatigue, body image complexities, and medical trauma (1)(2)(3). Psychological distress in pediatric patients with IBD has also been associated with nonadherence (4), which may negatively impact medical outcomes and subsequent increased utilization of medical services (5).…”

“…The COVID-19 pandemic has also impacted psychosocial needs in pediatric patients with IBD, with pandemic-related disruptions negatively contributing to both caregiver and child well-being (7). Taken together, there has been a call for increased engagement with psychosocial providers and routine mental health screenings for patients throughout pediatric IBD care given the dynamic nature of psychosocial needs of patients and caregivers alike (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

JPGN and the Year 2022

“…Known as pediatric medical traumatic stress (PMTS), post-traumatic stress symptoms from medical experiences were explored in children with chronic gastrointestinal diseases. This cross-sectional study of children and adolescents with inflammatory bowel disease (IBD), chronic pancreatitis, and CF used validated, self-report measures to evaluate potentially traumatic events (PTEs) and PMTS (17). Over two-thirds of children reported a medical PTE (91 of 132, 69%) and over a third had PMTS symptoms (48 of 132; 36%).…”