Delusions Common in Pediatric ICU

Hallucinations during use of sedatives increase risk of post-traumatic stress, study finds

By Serena Gordon
HealthDay Reporter

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THURSDAY, May 1 (HealthDay News) -- About one-third of children in pediatric intensive care units experience delusions, and those delusional memories put youngsters at a higher risk of developing post-traumatic stress syndrome after their hospital stay.

Delusions were more common in children who had to be sedated for more than two days, and in youngsters who were admitted on an emergency basis, according to a study in the first May issue of the American Journal of Respiratory and Critical Care Medicine.

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"In the majority of cases, these delusional memories consisted of one or more hallucinations which were often frightening and which the children could still recall vividly," said study author Gillian Colville, a consultant clinical psychologist and head of the pediatrics psychology service at St. George's Hospital in London. "[Children] reported seeing rats, cats, scorpions on the walls and, in some cases, crawling on the bed, and a couple of children were convinced that their parents had been replaced by imposters."

The timing of these hallucinations was usually around the time the children were being weaned off sedatives. Such medications are used to help control pain and anxiety in children, and in adults, who need intensive medical care.

"Sedatives, and benzodiazepines in particular, interfere with the ability to form new memories, and part of what they do is alter how you remember what's going on," said Dr. Scott Watson, a pediatric intensivist in the division of critical care medicine at Children's Hospital of Pittsburgh. "Sedating medications also interfere with normal sleep, so processing information and memory is more difficult."

However, because being in intensive care is a stressful experience itself, the authors aren't recommending that the use of sedatives be discontinued but suggest that additional studies be done in children to see if periods of interrupted sedation might lower rates of delirium.

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