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Children's Factual and Delusional Memories of Intensive Care

¹ Pediatric Psychology Service, St. George's Hospital, London, United Kingdom; ² Community Health Sciences, St. George's University of London, London, United Kingdom; and ³ Pediatric Intensive Care Unit, Great Ormond Street Hospital for Children, London, United Kingdom

Correspondence and requests for reprints should be addressed to Gilian Colville, B.Sc., M.Phil., Consultant Clinical Psychologist, Pediatric Psychology Service, St. George's Hospital, London SW17 0QT, UK. E-mail: gcolvill{at}sgul.ac.uk

Rationale: Delusional memories are significantly associated with post-traumatic stress in adult patients after intensive care.

Objectives: In this study, we attempted to establish whether this relationship was found in children. We also examined the association between factual memory and distress.

Methods: One hundred two consecutive children, aged between 7 and 17 years, were interviewed about their pediatric intensive care unit (PICU) experience 3 months after discharge from a PICU. Principal measures were the ICU Memory Tool (a checklist of intensive care memories) and an abbreviated version of the Impact of Event Scale (a screen for post-traumatic stress disorder).

Measurements and Main Results: In total, 64 of 102 (63%) children reported at least one factual memory of their admission and 33 of 102 (32%) reported delusional memories, including disturbing hallucinations. Traumatic brain injury was negatively associated with factual memory (odds ratio, 0.23; 95% confidence interval [CI], 0.09–0.58; P = 0.002). Longer duration of opiates/benzodiazepines was associated with delusional memory (odds ratio, 4.98; 95% CI, 1.3–20.0; P = 0.023). Post-traumatic stress scores were higher in children reporting delusional memories (adjusted difference, 3.0; 95% CI, 0.06–5.9; P = 0.045) when illness severity and emergency status were controlled for. Factual memory was not significantly associated with post-traumatic stress.

Conclusions: This study indicates that delusional memories are reported by almost one-third of children and are associated both with the duration of opiates/benzodiazepines and risk of post-traumatic stress. More research is needed on the presence of delusional memories and associated risk factors in children receiving intensive care treatment.

Key Words: post-traumatic stress • hallucinations • memory • opiates • benzodiazepines

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Delusional memories are associated with post-traumatic stress in adult intensive care survivors, but little is known about the prevalence of such memories in children or their association with subsequent psychological problems. What This Study Adds to the Field This study indicates that delusional memories are reported by almost one-third of children and are associated both with the duration of administration of benzodiazepines/opiates and subsequent risk of post-traumatic stress.