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

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 careg...

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Bibliographic Details
Main Authors: Brianna K. Rosgen, Karla D. Krewulak, Judy E. Davidson, E. Wesley Ely, Henry T. Stelfox, Kirsten M. Fiest
Format: Article
Language:English
Published: BMC 2021-04-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-021-03200-7
Description
Summary: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.
ISSN:1471-244X