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. 2020 Jan-Feb:62:87-92.
doi: 10.1016/j.genhosppsych.2019.12.003. Epub 2019 Dec 20.

Baseline resilience and depression symptoms predict trajectory of depression in dyads of patients and their informal caregivers following discharge from the Neuro-ICU

Emma Meyers  1 , Ann Lin  2 , Ethan Lester  3 , Kelly Shaffer  4 , Jonathan Rosand  5 , Ana-Maria Vranceanu  6
Affiliations

Baseline resilience and depression symptoms predict trajectory of depression in dyads of patients and their informal caregivers following discharge from the Neuro-ICU

Emma Meyers et al. Gen Hosp Psychiatry. 2020 Jan-Feb.

Abstract

Objective: To explore the impact of resiliency factors on the longitudinal trajectory of depressive symptoms in patients admitted to the Neuroscience Intensive Care Unit (Neuro-ICU) and their family caregivers.

Materials and methods: Patients (N = 102) and family caregivers (N = 103) completed self-report assessments of depressive symptoms (depression subscale of the Hospital Anxiety and Depression Scale; HADS-D) and resiliency factors (i.e., mindfulness and coping) during Neuro-ICU hospitalization. The HADS-D was administered again at 3 and 6 months after discharge. The Actor-Partner Interdependence Model (APIM) was used to assess patient-caregiver interdependence.

Results: Baseline rates of clinically significant depressive symptoms were high among patients (23%) and caregivers (19%), and remained elevated through 6-months. Higher depressive symptoms predicted higher levels of symptoms at the subsequent timepoint (ps < 0.05). Higher baseline mindfulness and coping were associated with lower levels of depressive symptoms at all timepoints (ps < 0.001). APIM analysis showed that one's own higher baseline mindfulness was associated with concurrent levels of depressive symptoms in a partner (p < 0.05).

Conclusions: Depressive symptoms in Neuro-ICU patient-caregiver dyads are high through 6 months. Mindfulness is protective against depressive symptoms and interdependent between patients and caregivers. Early, dyadic, mindfulness-based interventions may prevent the development of chronic depression in both patients and caregivers.

Keywords: Actor-partner interdependence model; Depression; Informal caregiver; Neuroscience ICU; Resilience.

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Conflict of interest statement

Conflicts of Interest

Dr. Rosand reports serving as a consultant for Boehringer Ingelheim, Pfizer and New Beta Innovation. No other authors report conflicts.

Figures

Figure 1.
Figure 1.
Actor-Partner Interdependence modeling (APIM) for resilience factors and depression symptoms at baseline, 3, and 6 months. Values represent standardized beta coefficients. Only significant paths shown.
See this image and copyright information in PMC

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