Parental experiences in the NICU are often characterized by psychological stress and anxiety following the birth of a critically ill or premature infant. Such stress can have a negative impact on parents and their vulnerable infants during NICU hospitalization as well as after discharge. These infants are also at increased risk for adverse developmental, cognitive, academic, and mental health outcomes. Identifying parents at risk for psychological distress is important and feasible with the use of well-validated screening instruments. Screening for psychological distress is essential for identifying families in need of referral for psychological support and resources. Numerous interventions have been implemented in the NICU to support parents. These include staff-based support such as wellness rounds and education in developmental care as well as parental-based support that includes cognitive behavioral therapy and home visitation programs. Comprehensive interventions should use a multidisciplinary approach that involves not only NICU staff but also key stakeholders such as social workers, spiritual/religious representatives, specialists in developmental care, and psychiatrists/psychologists to help support families and facilitate the transition to the home. Future efforts should include raising awareness of the psychological stresses of NICU parents and encouraging the development of programs to provide parents with psychological support.
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August 2021
Perspectives|
August 01 2021
Parental Stress and Mental Health Symptoms in the NICU: Recognition and Interventions
Janine Bernardo, MD, MPH;
Janine Bernardo, MD, MPH
*Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
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Sharla Rent, MD;
Sharla Rent, MD
†Division of Neonatal Medicine, Department of Pediatrics, Duke University, Durham, NC
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AnnaMarie Arias-Shah, MD;
AnnaMarie Arias-Shah, MD
‡Division of Neonatology, Department of Pediatrics, Children's Hospital of Orange County, Orange, CA
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Margaret K. Hoge, MD;
Margaret K. Hoge, MD
§Department of Developmental and Behavioral Pediatrics, UT Southwestern Dallas, Dallas, TX
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Richard J. Shaw, MD
Richard J. Shaw, MD
¶Division of Child Psychiatry, Stanford University School of Medicine, Palo Alto, CA
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AUTHOR DISCLOSURES
Dr Hoge has a research grant from Jerry M. Lewis, MD, Mental Health Research Foundation. Dr Shaw has publishing royalties from American Psychiatric Association Publishing. Drs Bernardo, Rent, and Arias-Shah have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Neoreviews (2021) 22 (8): e496–e505.
Citation
Janine Bernardo, Sharla Rent, AnnaMarie Arias-Shah, Margaret K. Hoge, Richard J. Shaw; Parental Stress and Mental Health Symptoms in the NICU: Recognition and Interventions. Neoreviews August 2021; 22 (8): e496–e505. https://doi.org/10.1542/neo.22-8-e496
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