Depression Negatively Impacts Dyadic Quality of Life Following Neuro-ICU Admission: A Prospective Study of Cognitively Intact Patients and Caregivers

• Published in: International journal of behavioral medicine Vol. 31; no. 1; pp. 97 - 108
• Main Authors: Quinn, Patricia A., Mace, Ryan A., Presciutti, Alex, Vranceanu, Ana-Maria
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2024; Springer Nature B.V
• Subjects: Anxiety; Caregivers; Family Medicine; Full Length Manuscript; General Practice; Health Psychology; Medicine; Medicine & Public Health; Mental depression; Mental health; Quality of life; Depression; Anxiety; Neurological injuries; Actor-partner interdependence model; Quality of life
• ISSN: 1070-5503; 1532-7558
• DOI: 10.1007/s12529-022-10149-8

Background Admission to a neurological intensive care unit (Neuro-ICU) can increase risk for depressive and anxiety symptoms for both patients and caregivers. To better understand the long-term mental health impact of a Neuro-ICU admission, we examined the dyadic interdependence between depression and anxiety at Neuro-ICU admission with 3-month quality of life (QoL) for patients and caregivers in a longitudinal, observational cohort study. Method We assessed depressive and anxiety symptoms (Hospital Anxiety and Depression Scale; HADS) reported by neurologically intact patients ( n  = 72) and their caregivers ( n  = 72) within 2 weeks of Neuro-ICU admission (baseline) and 3-months post-discharge (follow-up). We examined the longitudinal association between dyadic depression and anxiety at Neuro-ICU admission and 3-month QoL (World Health Organization; QOL-BREF) across four domains (Physical, Psychological, Social relationships, and Environmental QoL) in separate actor-partner interdependence models (APIM) for patients and caregivers. Results In the overall models, patients’ own baseline depression levels were negatively associated with their own 3-month QoL in all domains ( β  =  − 0.53 to − 0.64, p  < 0.001), and for caregivers, only in the psychological ( β  =  − 0.73, p  < .001) and social relationships ( β  =  − 0.56, p  < .001) domains. No actor effects were found for one’s own baseline anxiety impacting one’s own 3-month QoL. Partner effects for one’s own depression were significant for caregivers on patients’ 3-month psychological ( β  =  − 0.26, p  < .02) and environmental ( β  =  − 0.29, p  < .03) QoL, as well as for patients on caregiver’s 3-month psychological QoL ( β  = 0.25, p  < .02). No partner effects were significant in association with baseline anxiety and 3-month QoL in both patients and caregivers. Conclusion Neuro-ICU patients’ and caregivers’ baseline depression has significant negative impacts on their own long-term QoL. Caregivers demonstrate significant negative impacts on patient long-term QoL in domains related to emotional distress and caregiver burden. Early identification of mental health symptoms, especially depression, during Neuro-ICU admission may provide an intervention opportunity to improve QoL post-discharge for both dyad members.