Adults with a myriad of medical and surgical conditions are at risk for pain, delirium, and disfigurement. Needless to say, these critical illnesses are profoundly stressful for patients and their caregivers. However, physicians rarely consider the reactions of children to their parents’ illnesses. The article presents the case of a 15-year-old girl who developed posttraumatic stress disorder following her mother’s severe burn and complicated course in a critical care unit; the case is used to discuss strategies for the detection of psychological vulnerability and for the implementation of care. By learning more about the children of adult patients, by screening for interpersonal dysfunction, and by maximizing support systems, clinicians can improve function and minimize distress.
American Psychiatric Association. Diagnostic and Statistical Manual. 4th ed, text revision. Washington, DC: American Psychiatric Association; 2000.
2.
Pynoos RS, Frederick C, Nader K, et al.Life threat and post-traumatic stress in school-aged children. Arch Gen Psychiatry. 1987;44: 1057-1063.
3.
Terr LC.Childhood traumas: an outline and overview. Am J Psychiatry. 1991;148: 10-20.
4.
Stoddard FJ, Sheridan RL, Saxe GN, et al.Treatment of pain in acutely burned children. J Burn Care Rehabil. 2002;23: 135-156.
5.
Rizzone LP, Stoddard FJ, Murphy JM, Kruger LJ.Posttraumatic stress disorder in mothers of children and adolescents with burns. J Burn Care Rehabil. 1994;15: 158-163.
6.
Mancuso MG, Bishop S, Blakeney P, Robert R, Gaa J.Impact on the family: psychosocial adjustment of siblings of children who survive serious burns. J Burn Care Rehabil. 2003;24: 110-118.
7.
Emde RN.Early emotional development: new modes of thinking for research and intervention. Pediatrics. 1998; 102(5 suppl E): 1236-1243.
8.
Rauch PK, Muriel AC.Raising an Emotionally Healthy Child When a Parent Is Sick. Boston, Mass: McGraw-Hill; 2005.
9.
Rauch PK, Muriel AC, Cassem NH: Parents with cancer: who’s looking after the children?J Clin Oncol. 2003;21(9 suppl): 117-121.
