Robaey P: Posttraumatic stress symptoms and medical procedures in children

Objective: To focus on posttraumatic stress symptoms after childhood diseases such as cancer, organ transplantation, and severe burns. Methods: Differential diagnoses, risk factors, and treatment aspects (psychological and pharmacological) are dis-cussed. Results: The concept of adjustment problems in chronic or severe illnesses is widely used in pediatrics. Many aspects of severe childhood diseases are traumatic, as defined by the DSM-IV: severe illnesses are life-threatening, medical procedures threaten the child’s physical integrity, and disorganized behaviour periods are common. Conclusion: This concept, which remains insufficiently investigated, is a promising area of investigation for prospective and prevention studies. (Can J Psychiatry 1997;42:611–616) Key Words: posttraumatic stress, cognitive development, tertiary care Adjustment problems in chronic or severe illnesses arewidely applied in pediatrics. These problems are defined as states of subjective distress and emotional disturbance that significantly interfere with occupational and social function-ing (1). To date, 2 models have been used to study adjustmen