Emma Meyers1, Ann Lin2, Ethan Lester3, Kelly Shaffer4, Jonathan Rosand5, Ana-Maria Vranceanu6. 1. Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Neuroscience Intensive Care Unit, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. 2. Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 3. Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 4. Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, USA. 5. Henry and Allison McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Neuroscience Intensive Care Unit, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. 6. Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Henry and Allison McCance Center for Brain Health, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Neuroscience Intensive Care Unit, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. Electronic address: avranceanu@mgh.harvard.edu.
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.
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.
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Authors: Sarah M Bannon; Talea Cornelius; Melissa V Gates; Ethan Lester; Ryan A Mace; Paula Popok; Eric A Macklin; Jonathan Rosand; Ana-Maria Vranceanu Journal: Health Psychol Date: 2021-09-09 Impact factor: 4.267
Authors: Ethan G Lester; Ryan A Mace; Sarah M Bannon; Paula J Popok; Melissa V Gates; Emma Meyers; Tara Tehan; Danielle Sagueiro; Jonathan Rosand; Eric A Macklin; Ana-Maria Vranceanu Journal: Neurocrit Care Date: 2021-04-21 Impact factor: 3.210
Authors: Sarah Bannon; Ethan G Lester; Melissa V Gates; Jessica McCurley; Ann Lin; Jonathan Rosand; Ana-Maria Vranceanu Journal: Pilot Feasibility Stud Date: 2020-05-25
Authors: Ana-Maria Vranceanu; Sarah Bannon; Ryan Mace; Ethan Lester; Emma Meyers; Melissa Gates; Paula Popok; Ann Lin; Danielle Salgueiro; Tara Tehan; Eric Macklin; Jonathan Rosand Journal: JAMA Netw Open Date: 2020-10-01