April 26, 2022 – Family members of COVID-19 patients in intensive care may develop symptoms of anxiety, depression, and posttraumatic stress disorder, according to a new study published in JAMA Internal Medicine.

Family members described feelings of distrust, loss of control, and uncertainty around difficult decisions. Although having a loved one in the intensive care unit has always been stressful, the COVID-19 pandemic likely made the experience worse due to visit restrictions and rapid declines in patient health, the study authors wrote.

“The sudden change in health status is Mom or Dad was healthy yesterday and now they’re in the ICU on life support,” Timothy Amass, MD, the lead study author and an assistant professor of medicine at the University of Colorado, told CNN.

Amass and colleagues surveyed 330 family members of hospitalized COVID-19 patients about 3 months after their loved ones were admitted to the ICU. The patients were in the ICU between February and July 2020 at 12 hospitals in Colorado, Louisiana, Massachusetts, New York, and Washington.

About 40% of the family members were the patient’s child, and 25% were the patient’s spouse or partner. More than 69% were women, and their average age was 51. About 41% of the patients died in the hospital, and many of the family members had limited contact with their loved one.

Overall, 63% of family members surveyed had significant symptoms of PTSD, while 31% had significant symptoms of anxiety and depression. Higher PTSD symptom scores were found among women, Hispanic people, and family members who had previous medication use for mental health conditions.

Family members of patients who died had higher scores for depression, though not higher scores for anxiety or PTSD.

During follow-up surveys several months later, about 48% of family members still showed significant symptoms of PTSD, and 25% had significant symptoms of anxiety and depression.

In interviews with 74 people in the study, family members reported a mix of experiences. Some felt connected and involved, even when they couldn’t be in the room, when hospital staff set up video calls and provided daily updates. Others felt disconnected and afraid due to limited communication and rapid changes in their loved one’s health.

What’s more, family members with higher PTSD scores more commonly described feelings of distrust and concern about taking a doctor’s advice at face value without being in the ICU in person.

“What the literature really suggests was the more you can get someone involved at the bedside, the more empowered they feel to express their needs and the needs of their loved one,” Amass told CNN.

The responses suggest that the health care community can take two important steps to help families: Pay attention to their risk factors and empower family members, he said. Small acts of kindness, such as allowing patients to have photographs or gifts in the hospital room, could help family members feel more connected and in control, particularly when visitation is restricted.

Health care providers and family doctors may also want to find ways to engage with family members after an ICU stay to help them receive guidance.

“The scores on these surveys were so high that I would advocate for providers to actively screen these family members for depression, anxiety, and PTSD clinically so they can get therapy,” Amass said.

Show Sources

JAMA Internal Medicine: “Stress-Related Disorders of Family Members of Patients Admitted to the Intensive Care Unit With COVID-19.”

CNN: “Family members of Covid-19 ICU patients may emerge with a different condition, study says.”

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