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      PTSD in parents of children with severe diseases: a systematic review to face Covid-19 impact

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          The literature agrees on the impact of post-traumatic stress symptoms in parents of seriously ill children but there is less clarity about the real extent and gender differences of this psychopathological risk. The recent Covid-19 outbreak highlighted new burdens for researchers on Post Traumatic Stress Disorder (PTSD) and clear evidence-based knowledge on this issue is timely needed .


          In this review, we present a synthesis of the updated evidence on PTSD rates in parents of children with severe diseases.

          We also aim to try to understand if research in this field has been refined over time with the long-term intent to better face the new challenges of Covid-19 in the paediatric field.

          Data sources

          The PubMed database was searched.

          Study selection

          Studies were included if they assessed PTSD in parents of children diagnosed with physical illnesses.

          Data extraction

          Of 240 studies, 4 were included.


          Analysis of the 4 studies revealed 2 studies with PTSD rates around 20% and in line with previous best-evidence. All 4 studies tried to provide more data on fathers, however, all the studies present the lack of a control group.


          The limited number of studies, which also differ widely in the methodology used.


          Methodological errors evidenced in all the 4 studies limit their reliability, making the understanding of the paediatric caregiver’s concern regarding PTSD still difficult. More sound research is needed.

          Related collections

          Most cited references 39

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          Prevalence and predictors of PTSS during COVID-19 Outbreak in China Hardest-hit Areas: Gender differences matter

          Highlights • The prevalence of posttraumatic stress symptoms (PTSS) in China hardest-hit areas a month after the COVID-19 outbreak was 7%. • Hierarchical regression analysis and non-parametric test suggested that women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. • Participants with better sleep quality or less frequency of early awakenings reported lower PTSS.
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            Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.

            Little is known about the general population prevalence or severity of DSM-IV mental disorders. To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication. Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Nine thousand two hundred eighty-two English-speaking respondents 18 years and older. Twelve-month DSM-IV disorders. Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses. Latent class analysis detected 7 multivariate disorder classes, including 3 highly comorbid classes representing 7% of the population. Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.
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              Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project.

               V. Kovess,  F Mazzi,  S-I Joo (2003)
              To describe the 12-month and lifetime prevalence rates of mood, anxiety and alcohol disorders in six European countries. A representative random sample of non-institutionalized inhabitants from Belgium, France, Germany, Italy, the Netherlands and Spain aged 18 or older (n = 21425) were interviewed between January 2001 and August 2003. DSM-IV disorders were assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview (WMH-CIDI). Fourteen per cent reported a lifetime history of any mood disorder, 13.6% any anxiety disorder and 5.2% a lifetime history of any alcohol disorder. More than 6% reported any anxiety disorder, 4.2% any mood disorder, and 1.0% any alcohol disorder in the last year. Major depression and specific phobia were the most common single mental disorders. Women were twice as likely to suffer 12-month mood and anxiety disorders as men, while men were more likely to suffer alcohol abuse disorders. ESEMeD is the first study to highlight the magnitude of mental disorders in the six European countries studied. Mental disorders were frequent, more common in female, unemployed, disabled persons, or persons who were never married or previously married. Younger persons were also more likely to have mental disorders, indicating an early age of onset for mood, anxiety and alcohol disorders.

                Author and article information

                Ital J Pediatr
                Ital J Pediatr
                Italian Journal of Pediatrics
                BioMed Central (London )
                14 January 2021
                14 January 2021
                : 47
                [1 ]GRID grid.5395.a, ISNI 0000 0004 1757 3729, Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, , University of Pisa, ; Pisa, Italy
                [2 ]GRID grid.5395.a, ISNI 0000 0004 1757 3729, Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, , University of Pisa, ; Pisa, Italy
                [3 ]GRID grid.5395.a, ISNI 0000 0004 1757 3729, Department of Clinical and Experimental Medicine, Pediatric Clinic, Azienda Ospedaliero-Universitaria Pisana, , University of Pisa, ; Pisa, Italy
                [4 ]GRID grid.5395.a, ISNI 0000 0004 1757 3729, Pediatric Neurology, Pediatric Department, Azienda Ospedaliero- Universitaria Pisana, , University of Pisa, ; Pisa, Italy
                [5 ]GRID grid.5606.5, ISNI 0000 0001 2151 3065, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, , University of Genoa, ; Genoa, Italy
                [6 ]GRID grid.419504.d, ISNI 0000 0004 1760 0109, Pediatric Neurology and Muscular Diseases Unit, , IRCCS Istituto Giannina Gaslini, ; Genoa, Italy
                © The Author(s) 2021

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                ptsd, severe diseases, caregivers, parents, covid19


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