Journal of General Internal Medicine

, Volume 23, Issue 11, pp 1871–1876

Posttraumatic Stress and Complicated Grief in Family Members of Patients in the Intensive Care Unit

  • Wendy G. Anderson
  • Robert M. Arnold
  • Derek C. Angus
  • Cindy L. Bryce
Original Article

DOI: 10.1007/s11606-008-0770-2

Cite this article as:
Anderson, W.G., Arnold, R.M., Angus, D.C. et al. J GEN INTERN MED (2008) 23: 1871. doi:10.1007/s11606-008-0770-2



Family members of patients in intensive care units (ICUs) are at risk for mental health morbidity both during and after a patient’s ICU stay.


To determine prevalences of and factors associated with anxiety, depression, posttraumatic stress and complicated grief in family members of ICU patients.


Prospective, longitudinal cohort study.


Fifty family members of patients in ICUs at a large university hospital participated.


We used the Control Preferences Scale to determine participants’ role preferences for surrogate decision-making. We used the Hospital Anxiety and Depression Scale, Impact of Event Scale, and Inventory of Complicated Grief to measure anxiety and depression (at enrollment, 1 month, 6 months), posttraumatic stress (6 months), and complicated grief (6 months).


We interviewed all 50 participants at enrollment, 39 (78%) at 1 month, and 34 (68%) at 6 months. At the three time points, anxiety was present in 42% (95% CI, 29–56%), 21% (95% CI, 10–35%), and 15% (95% CI, 6–29%) of participants. Depression was present in 16% (95% CI, 8–28%), 8% (95% CI, 2–19%), and 6% (95% CI, 1–18%). At 6 months, 35% (95% CI, 21–52%) of participants had posttraumatic stress. Of the 38% who were bereaved, 46% (95% CI, 22–71%) had complicated grief. Posttraumatic stress was not more common in bereaved than nonbereaved participants, and neither posttraumatic stress nor complicated grief was associated with decision-making role preference or with anxiety or depression during the patient’s ICU stay.


Symptoms of anxiety and depression diminished over time, but both bereaved and nonbereaved participants had high rates of posttraumatic stress and complicated grief. Family members should be assessed for posttraumatic stress and complicated grief.


critical care primary care psychology 

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Wendy G. Anderson
    • 1
  • Robert M. Arnold
    • 2
    • 3
    • 4
  • Derek C. Angus
    • 5
    • 6
  • Cindy L. Bryce
    • 2
    • 6
  1. 1.Department of Medicine, Division of Hospital Medicine and Palliative Care ProgramUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Division of General Internal Medicine, Department of MedicineUniversity of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Institute for Doctor-Patient CommunicationUniversity of Pittsburgh School of MedicinePittsburghUSA
  4. 4.Institute to Enhance Palliative CareUniversity of Pittsburgh School of MedicinePittsburghUSA
  5. 5.Department of Critical Care Medicine and Clinical Research, Investigation, and Systems Modeling of Acute Illness LaboratoryUniversity of Pittsburgh School of MedicinePittsburghUSA
  6. 6.Center for Research on Health Care and the Section for Decision Sciences and Clinical Systems ModelingUniversity of Pittsburgh School of MedicinePittsburghUSA

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