Table 2.
Characteristics and Main Results of Studies Included in the Analysis of the Review
| First Author Year Country |
Sample Characteristic | Design c | Surgical Procedure | Outcome (Instrument) | Time of Assessment | Main Result and Prevalence | Risk of Bias d | |
|---|---|---|---|---|---|---|---|---|
|
Ben-Amitay et al. (2006) Israel |
N = 40 (52.5% boys); ages 6 – 18 (M = 13.05, SD = 2.7) |
P | elective surgery |
PTSD (CPTS-RI) Depressive symptoms (CDI) Anxiety symptoms (RCMAS) |
Admission day (Stage 1) 1 month after surgery (Stage 2), 6 months after surgery (Stage 3) |
PTSS (7.7% mild), depressive symptoms (5%) were low and decreased over time. Anxiety symptoms (12.5%) were low, but did not change over time. (Data based on Stage 2) | 7 | |
|
Ben-Ari et al. (2018) Israel |
N = 79 (65% boys); ages 1 – 6 (M = 4.5, SD = 2.8) |
P | minor surgery: 50%, other kinds of surgery: 32%, without surgery 15%, burns: 3% |
PTSD (PTSDSSI, PCASS) Internalizing and externalizing symptoms (CBCL) |
3 to 5 months post-discharge | 10.39% of the children exhibit posttraumatic symptoms. In the CBCL’s general scale 11% of children were in the clinical and 4% in the borderline range. Internalizing problems were reported the most | 6 | |
|
Ben-Ari et al. a (2019) Israel |
N = 30 (47% boys); ages 1 – 13 (M = 4.23, SD = 3.1) |
P | surgery for congenital melanocytic nevi |
PTSD (PTSDSSI, PCASS, UCLA-PTSD-RI-P) Internalizing and externalizing symptoms (CBCL) |
Before hospitalization, 4 months post-discharge |
33.3% of the children met PTSD diagnosis In the CBCL’s general scale 26.7% of children were in the borderline range and 30% in the clinical range. Internalizing problems were reported the most |
7 | |
|
Ben-Ari et al. b (2019) Israel |
N = 88 (58% boys); ages 6 – 13 (M = 9.03, SD = 2.3) |
P | surgery: 80.7%, without surgery: 19.3% |
PTSD (UCLA-PTSD-RI-P) Internalizing and externalizing symptoms (CBCL) |
Baseline, 3 to 5 months post-discharge |
10.2% of the children fully met PTSD diagnosis, whereas 26.4% met partial diagnosis In the CBCL’s general scale 27.3% of children were in the clinical range |
7 | |
|
Connolly et al. (2004) USA |
N = 43 (60% boys); ages 5 – 12 (M = 8.2, SD = 2.5) |
P | cardiac surgery | PTSD (DISC) | 4 to 8 weeks post-discharge | 12% of the children met diagnostic criteria for PTSD, and 12% had symptoms but did not meet criteria | 6 | |
|
DeMaso et al. (2014) USA |
N = 139 age: M = 16.01, SD = 0.5 |
P | arterial switch operation | mood, anxiety and disruptive behavior disorders (K-SADS-PL) | 16 years after operation as an infant |
The most common psychiatric diagnosis was ADHD (16%) 4% had symptoms of mood disorder, 5% of anxiety disorder, and 16% of disruptive behavior disorder |
7 | |
|
Kubota et al. (2011) Japan |
N = 72 (51.39% boys); ages 6 – 17 |
R | major neonatal surgery | Internalizing and externalizing symptoms (CBCL) | 6 to 17 years after surgery as an infant | Among the subjects having the most typical neonatal surgical diseases requiring long-term follow-up 45% scored in the clinical range of the CBCL | 5 | |
|
Lopez et al. (2008) Switzerland |
N = 7 (85.71% boys) ages 8 – 16 |
R | intraoperative awareness | PTSD (new questionnaire based on CPTS-RI) | 8 to 15 months after surgery | None of the children demonstrated symptoms of PTSD (0%) | 4 | |
|
Phelan et al. (2009) Australia |
N = 4 (25% boys); ages 6 – 10 |
R | intraoperative awareness | PTSD (TSCC-A) | 4 to 5 years after surgery | None of the children were in the clinically significant range of any symptoms of posttraumatic stress (0%) | 5 | |
|
Sarrechia et al. (2015) Belgium |
N = 48 (39.58% boys); Ages 6 – 12 (M = 9.25, SD = 1.75) |
R | open heart surgery or catheterization | Internalizing and externalizing symptoms (CBCL) | several years after surgery (not stated explicitly) | In the CBCL’s general scale 3.8% of children were in the borderline range and 8.1% in the clinical range | 5 | |
|
Toren and Horesh (2007) Israel |
N = 31 (61.29% boys); ages 10 – 21 (M = 14.7, SD = 0.3) |
C | cardiac surgery |
PTSS (UCLA-PTSD-RI) depressive symptoms (BDI) anxiety symptoms (SCARED) |
13.7 (2.48) years after surgery | A significant portion of children undergoing cardiac surgery display PTSD symptoms (29.03%), depressive (18.52%) and anxiety (16.13%) symptoms | 6 | |
N sample size, M mean, SD standard deviation, BDI Beck Depression Inventory, CBCL Achenbach's Child Behavior Checklist, CDI Children's Depression Inventory, Conners' ADHD attention-deficit/hyperactivity disorder, CPTS-RI Child Posttraumatic Stress Reaction Index Revision, DISC Diagnostic Interview Schedule for Children, K-SADS-PL Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version, PCASS Preschool Children's Assessment of Stress Scale, PTSD posttraumatic stress disorder, PTSS posttraumatic stress symptom, PTSDSSI Posttraumatic Stress Disorder Semistructured Interview, RCMAS Revised Children's Manifest Anxiety Scale, SCARED Screen for Child Anxiety Related Emotional Disorders, TSCC-A Trauma Symptom Checklist for Children Alternate version, UCLA-PTSD-RI University of California at Los Angeles- Post Traumatic Stress Disorder Reaction Index
aBen-Ari et al. 2019a
bBen-Ari et al. 2019c
cP = prospective; R = retrospective; C = cross-sectional
d8 or 9 = low risk of bias; 7 = moderate risk of bias; 6 or less = high risk of bias