title: Anxiety and Depressive Symptoms Among Two Seriously Medically Ill Populations and Their Family Caregivers: A Comparison and Clinical Implications.
abstract: BACKGROUND
  Anxiety and depression are common among patients with acute illness and their families. In oncology, psychosocial services addressing these symptoms are increasingly part of regular practice. Less is known about psychiatric distress among patients with acute neurological injury (ANI) and their family caregivers. To highlight this inequity in psychosocial intervention across medical services, we compared anxiety and depressive symptomatology shortly following diagnosis among patients facing incurable cancer or ANI and their family caregivers.
  
  
  METHODS
  Recruited from the same hospital, participants were patients within 8 weeks of receiving a diagnosis of incurable cancer (N = 350) and their family caregivers (N = 275; total patient/caregiver dyads = 275) and patients hospitalized in the Neuroscience ICU in the past 2 weeks (N = 81) and their family caregivers (N = 95; total dyads = 75). Participants reported anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale. Symptomatology was compared across illnesses using independent samples t-tests and multiple regressions controlling for differences in sample demographics.
  
  
  RESULTS
  Patients with ANI (M = 6.90) reported greater anxiety symptoms than those with cancer (M = 5.31, p < .001), while caregivers for patients with ANI (M = 5.45) reported greater depressive symptoms than caregivers for patients with cancer (M = 3.81, p < .001). Results remained when controlling for demographic differences between samples.
  
  
  CONCLUSIONS
  This is the first cross-comparison of psychiatric distress in patients and family caregivers affected by two distinct, life-threatening illnesses early in the illness trajectory. Findings support the priority of addressing psychiatric distress among patients with ANI and their family caregivers, as has been emphasized in the psychosocial oncology field.
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, One Bowdoin Square, 7th Floor, Suite 758, Boston, MA, 02114, USA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Shaffer
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, One Bowdoin Square, 7th Floor, Suite 758, Boston, MA, 02114, USA.|Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Jacobs
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, One Bowdoin Square, 7th Floor, Suite 758, Boston, MA, 02114, USA.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Coleman
authors.affiliation: Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Temel
authors.affiliation: Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rosand
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, One Bowdoin Square, 7th Floor, Suite 758, Boston, MA, 02114, USA.|Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Greer
authors.affiliation: Behavioral Medicine Service, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, One Bowdoin Square, 7th Floor, Suite 758, Boston, MA, 02114, USA. avranceanu@partners.org.
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Vranceanu
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*; D020196:Trauma, Nervous System / Q000451:nursing / Q000523:psychology*
keywords: Anxiety; Depression; Family caregiver; Incurable cancer; Neuroscience ICU; Psychosocial intervention