Skip to main content
Top
Published in: BMC Psychiatry 1/2021

Open Access 01-12-2021 | Mood Disorders | Research Article

Associations between caregiver-detected delirium and symptoms of depression and anxiety in family caregivers of critically ill patients: a cross-sectional study

Authors: Brianna K. Rosgen, Karla D. Krewulak, Judy E. Davidson, E. Wesley Ely, Henry T. Stelfox, Kirsten M. Fiest

Published in: BMC Psychiatry | Issue 1/2021

Login to get access

Abstract

Background

Witnessing delirium can be distressing for family caregivers (i.e., relatives or friends) of critically ill patients. This study aimed to evaluate associations between caregiver-detected delirium in critically ill patients and depression and anxiety symptoms in their family caregivers.

Methods

Consecutive adult patient-caregiver dyads were enrolled from a 28-bed medical-surgical intensive care unit. Patient delirium was screened for daily by family caregivers using the Sour Seven instrument. Family caregivers completed the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) instruments daily to assess their own depression and anxiety symptoms. Response feature analysis was used to handle repeated measures. Descriptive statistics and regression analyses were completed.

Results

One hundred forty-seven patient-caregiver dyads were enrolled. Clinically significant symptoms of depression and anxiety occurred in 27% and 35% of family caregivers, respectively. Caregiver-detected delirium occurred in 65% of patients, and was not associated with clinically significant caregiver depression (Odds Ratio [OR] 1.4, 95% Confidence Interval [95%CI] 0.6–3.1) or anxiety (OR 1.2, 95%CI 0.6–2.6) symptoms. When stratified by Sour Seven scores, scores 1–3 and 4–9 were associated with increased symptoms of anxiety (OR 3.1, 95%CI 1.3–7.0) and depression (OR 2.6, 95%CI 1.1–6.1) in family caregivers. Caregiver-detected delirium score was associated with severity of family caregiver anxiety symptoms (coefficient 0.2, 95%CI 0.1–0.4), but not depression symptoms (coefficient 0.2, 95%CI -0.0–0.3).

Conclusions

Caregiver-detected patient delirium was associated with increased depression and anxiety symptoms in family caregivers of critically ill patients. Further randomized research is required to confirm these associations.
Literature
3.
go back to reference van Beusekom I, Bakhshi-Raiez F, de Keizer N, Dongelmans D, van der Schaaf M. Reported burden on informal caregivers of ICU survivors: a literature review. Crit Care. 2016;20(1):16.CrossRef van Beusekom I, Bakhshi-Raiez F, de Keizer N, Dongelmans D, van der Schaaf M. Reported burden on informal caregivers of ICU survivors: a literature review. Crit Care. 2016;20(1):16.CrossRef
5.
go back to reference Ely E, Shintani A, Truman B, Speroff T, Gordon S, Harrell F, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;14(291):1753–2.CrossRef Ely E, Shintani A, Truman B, Speroff T, Gordon S, Harrell F, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;14(291):1753–2.CrossRef
21.
go back to reference American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, D.C: American Psychiatric Association; 2000. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, D.C: American Psychiatric Association; 2000.
23.
go back to reference Chang C: Response feature analysis of longitudinal data in medical research. 2000; 2000. Chang C: Response feature analysis of longitudinal data in medical research. 2000; 2000.
29.
go back to reference Cherak SJ, Rosgen BK, Amarbayan M, Wollny K, Doig CJ, Patten SB, et al. Mental Health Interventions to Improve Psychological Outcomes in Informal Caregivers of Critically Ill Patients: A Systematic Review and Meta-Analysis. Crit Care Med. 2021. Epub ahead of print. https://doi.org/10.1097/CCM.0000000000005011. Cherak SJ, Rosgen BK, Amarbayan M, Wollny K, Doig CJ, Patten SB, et al. Mental Health Interventions to Improve Psychological Outcomes in Informal Caregivers of Critically Ill Patients: A Systematic Review and Meta-Analysis. Crit Care Med. 2021. Epub ahead of print. https://​doi.​org/​10.​1097/​CCM.​0000000000005011​.
Metadata
Title
Associations between caregiver-detected delirium and symptoms of depression and anxiety in family caregivers of critically ill patients: a cross-sectional study
Authors
Brianna K. Rosgen
Karla D. Krewulak
Judy E. Davidson
E. Wesley Ely
Henry T. Stelfox
Kirsten M. Fiest
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-021-03200-7

Other articles of this Issue 1/2021

BMC Psychiatry 1/2021 Go to the issue