Associations between caregiver-perceived delirium in patients with cancer and generalized anxiety in their caregivers.
BACKGROUND
Delirium, a common complication of advanced cancer, may put caregivers at risk for poor mental health outcomes. We looked for a relationship between caregiver-perceived delirium in a patient with advanced cancer and rates of caregiver psychiatric disorders.


METHODS
Using cross-sectional data from 200 caregivers of patients with cancer with a life expectancy of less than 6 months, we determined the frequency of caregiver-perceived delirium, which was defined as caregivers who reported witnessing the patient "confused, delirious" on the Stressful Caregiving Response to Experiences of Dying (SCARED) weekly or more often. We tested for associations between caregiver-reported delirium and presence of caregiver mental disorders, using the Structured Clinical Interview for the DSM-IV to diagnose mental disorders and caregiver burden, as measured by the caregiver burden scale (CBS).


RESULTS
Of the 200 caregivers who completed the SCARED, 38 (19.0%) reported seeing the patient "confused, delirious" at least once per week in the month prior to study enrollment and 7 (3.5%) met criteria for generalized anxiety (GA). Caregivers of patients with caregiver-perceived delirium were 12 times more likely to have GA (odds ratio [OR] 12.12; p < 0.01). The relationship between caregiver-perceived delirium and caregiver GA persisted after adjusting for caregiver burden and exposure to other stressful patient experiences (OR = 9.99; p = 0.04).


CONCLUSIONS
This is the first report of an association between caregiver-perceived delirium and a caregiver mental health outcome. Further studies, using improved measures of delirium, are needed.
Buss
Mary K
MK
Center for Psycho-Oncology and Palliative Care Research, Division of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. mary_buss@dfci.harvard.edu
Vanderwerker
Lauren C
LC
Inouye
Sharon K
SK
Zhang
Baohui
B
Block
Susan D
SD
Prigerson
Holly G
HG
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D003071:Cognition; D003430:Cross-Sectional Studies; D003693:Delirium / Q000209:etiology / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D010166:Palliative Care; D010465:Perception; D011581:Psychological Tests; D011594:Psychometrics; D018570:Risk Assessment; D012307:Risk Factors; D013315:Stress, Psychological