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

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          Abstract

          Context

          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 .

          Objective

          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.

          Results

          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.

          Limitations

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

          Conclusions

          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 references39

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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 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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              Posttraumatic stress disorder in the National Comorbidity Survey.

              Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated life-time prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode. Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey. The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years. Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumas.
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                Author and article information

                Contributors
                aorsini.md@gmail.com
                Journal
                Ital J Pediatr
                Ital J Pediatr
                Italian Journal of Pediatrics
                BioMed Central (London )
                1824-7288
                14 January 2021
                14 January 2021
                2021
                : 47
                : 8
                Affiliations
                [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
                Author information
                http://orcid.org/0000-0001-5256-6573
                Article
                957
                10.1186/s13052-021-00957-1
                7807213
                33446246
                038d8ab3-d65b-4ee9-8ed0-32a063bd77d5
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 22 August 2020
                : 4 January 2021
                Categories
                Review
                Custom metadata
                © The Author(s) 2021

                Pediatrics
                ptsd,severe diseases,caregivers,parents,covid19
                Pediatrics
                ptsd, severe diseases, caregivers, parents, covid19

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