title: Emotional disorders in pairs of patients and their family members during and after ICU stay.
abstract: BACKGROUND
  Patients and family members undergo different experiences of suffering from emotional disorders during ICU stay and after ICU discharge. The purpose of this study was to compare the incidence of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in pairs (patient and respective family member), during stay at an open visit ICU and at 30 and 90-days post-ICU discharge. We hypothesized that there was a positive correlation with the severity of symptoms among pairs and different patterns of suffering over time.
  
  
  METHODS
  A prospective study was conducted in a 22-bed adult general ICU including patients with >48 hours stay. The Hospital Anxiety and Depression Scale (HADS) was completed by the pairs (patients/respective family member). Interviews were made by phone at 30 and 90-days post-ICU discharge using the Impact of Event Scale (IES) and the HADS. Multivariate models were constructed to predict IES score at 30 days for patients and family members.
  
  
  RESULTS
  Four hundred and seventy one family members and 289 patients were interviewed in the ICU forming 184 pairs for analysis. Regarding HADS score, patients presented less symptoms than family members of patients who survived and who deceased at 30 and 90-days (p<0.001). However, family members of patients who deceased scored higher anxiety and depression symptoms (p = 0.048) at 90-days when compared with family members of patients who survived. Patients and family members at 30-days had a similar IES score, but it was higher in family members at 90-days (p = 0.019). For both family members and patients, age and symptoms of anxiety and depression during ICU were the major determinants for PTSD at 30-days.
  
  
  CONCLUSIONS
  Anxiety, depression and PTSD symptoms were higher in family members than in the patients. Furthermore, these symptoms in family members persisted at 3 months, while they decreased in patients.
authors.affiliation: Intensive Care Unit, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91, São Paulo 01308-050, Brazil.
authors.forename: Renata Rego Lins
authors.initials: RR
authors.lastname: Fumis
authors.affiliation: Respiratory Intensive Care Unit, Pulmonary Division, Heart Institute, Hospital das Clínicas, University of São Paulo, Rua Dr. Enéas de Carvalho Aguiar, 255, São Paulo 05403-900, Brazil.
authors.forename: Otavio T
authors.initials: OT
authors.lastname: Ranzani
authors.affiliation: Intensive Care Unit, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91, São Paulo 01308-050, Brazil.
authors.forename: Paulo Sérgio
authors.initials: PS
authors.lastname: Martins
authors.affiliation: Intensive Care Unit, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91, São Paulo 01308-050, Brazil.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Schettino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D003422:Critical Care / Q000523:psychology*; D003863:Depression / Q000453:epidemiology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*