Stress, anxiety, and depression : a comparative study of perceptions of patients in the ICU, other wards and their family caregivers in a low middle income country

Abstract

Developed countries report higher ICU-related mental-health complications. The absence of non-ICU comparators limits interpretation and comparability across socioculturally diverse populations. Having found low levels of mental health complications in our ICU patients, we compared anxiety, depression, posttraumatic stress symptoms (PTSS), quality of life (QOL), and self-reported stressors in ICU (n ¼ 28), ward (n ¼ 34) patients and family caregivers (n ¼ 30) in a cross-sectional study in a tertiary teaching hospital. Hospital Anxiety and Depression Scale (HADS), Impact of Events revised IES-R, European Quality of Life 5 Dimensions 3 levels (EQ5D 3L) were used. Clinically relevant anxiety, depression (HADS 8), and PTSS (IES-R 30) were comparable amongst the ICU patients (46.4%, 46.4%, 10.7%), ward patients (53.3%, 30.0%, 6.7%), and caregivers (55.9%, 29.4%, 0%) respectively. Avoidance as PTSS subgroup was significantly higher in ICU patients and caregivers. IES-R scores were significantly less when only the ICU experiences were considered. QOL was significantly worse in ICU patients. Self-reported stressors were comparable in the groups; however after correcting baseline factors, un employment contributed significantly to higher PTSS, anxiety and depression. While the rates of anxiety/depression were similar, lower PTSS in comparison to reports from developed countries suggest future studies to focus ICU experience, confounding non-clinical stressors and cultural issues.