Anxiety and Depressive Symptoms Among Two Seriously Medically Ill Populations and Their Family Caregivers: A Comparison and Clinical Implications

Abstract

Anxiety and depression are common among patients with acute illness and their families. In oncology, psychosocial services addressing these symptoms are increasingly part of regular practice. Less is known about psychiatric distress among patients with acute neurological injury (ANI) and their family caregivers. To highlight this inequity in psychosocial intervention across medical services, we compared anxiety and depressive symptomatology shortly following diagnosis among patients facing incurable cancer or ANI and their family caregivers. Recruited from the same hospital, participants were patients within 8weeks of receiving a diagnosis of incurable cancer (N=350) and their family caregivers (N=275; total patient/caregiver dyads=275) and patients hospitalized in the Neuroscience ICU in the past 2weeks (N=81) and their family caregivers (N=95; total dyads=75). Participants reported anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale. Symptomatology was compared across illnesses using independent samples t-tests and multiple regressions controlling for differences in sample demographics. Patients with ANI (M=6.90) reported greater anxiety symptoms than those with cancer (M=5.31, p<.001), while caregivers for patients with ANI (M=5.45) reported greater depressive symptoms than caregivers for patients with cancer (M=3.81, p<.001). Results remained when controlling for demographic differences between samples. This is the first cross-comparison of psychiatric distress in patients and family caregivers affected by two distinct, life-threatening illnesses early in the illness trajectory. Findings support the priority of addressing psychiatric distress among patients with ANI and their family caregivers, as has been emphasized in the psychosocial oncology field.