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

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Abstract

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.

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Data Availability

The data that support the findings of this study are available from the corresponding author, Dr. Ana-Maria Vranceanu, upon reasonable request.

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Authors and Affiliations

  1. Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, One Bowdoin Square, Suite 100, Boston, MA, USA

    Patricia A. Quinn, Ryan A. Mace, Alex Presciutti & Ana-Maria Vranceanu

  2. Harvard University, Cambridge, MA, USA

    Patricia A. Quinn

  3. Department of Psychology, University of Colorado Denver, Denver, CO, USA

    Alex Presciutti

  4. Harvard Medical School, Boston, MA, USA

    Ryan A. Mace & Ana-Maria Vranceanu

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Correspondence to Ana-Maria Vranceanu.

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Quinn, P.A., Mace, R.A., Presciutti, A. et al. Depression Negatively Impacts Dyadic Quality of Life Following Neuro-ICU Admission: A Prospective Study of Cognitively Intact Patients and Caregivers. Int.J. Behav. Med. 31, 97–108 (2024). https://doi.org/10.1007/s12529-022-10149-8

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