Anxiety and Depression in the Relatives of COVID-19 and Non-COVID-19 Intensive Care Patients During the Pandemic

Behiye Deniz Kosovali; Busra Tezcan; Ismail Aytaç; Tulay Tuncer Peker; Ozlem B Soyal; Nevzat Mehmet Mutlu

doi:10.7759/cureus.20559

Anxiety and Depression in the Relatives of COVID-19 and Non-COVID-19 Intensive Care Patients During the Pandemic

Cureus. 2021 Dec 21;13(12):e20559. doi: 10.7759/cureus.20559. eCollection 2021 Dec.

Authors

Behiye Deniz Kosovali¹, Busra Tezcan¹, Ismail Aytaç², Tulay Tuncer Peker³, Ozlem B Soyal⁴, Nevzat Mehmet Mutlu¹

Affiliations

¹ Department of Critical Care Medicine, Health of Science Ankara City Hospital, Ankara, TUR.
² Department of Anesthesiology and Reanimation, Health of Science Ankara City Hospial, Ankara, TUR.
³ Department of Critical Care Medicine, Gulhane Education and Research Hospital, Ankara, TUR.
⁴ Department of Anesthesiology and Reanimation, Health of Science Ankara City Hospital, Ankara, TUR.

Abstract

Background and aim In the literature, there is no study on the anxiety and depression status of the relatives of intensive care COVID-19 and non-COVID-19 patients during the pandemic period. In this study, we aimed to compare the risk of developing anxiety and depression in the relatives of COVID-19 and non-COVID-19 intensive care patients during the pandemic, and also to determine the factors that may cause anxiety and depression. Materials and methods Relatives of patients admitted to Ankara City Hospital COVID-19 (n=45) and non-COVID-19 (n=45) intensive care units between 15 May and 31 July 2021 were included in this prospective study. The Hospital Anxiety and Depression Scale (HADS) questionnaire was administered to the relatives of the patients within the first 48 hours of their admission to the intensive care unit. The answers were recorded and HADS, HADS-A (anxiety) and HADS-D (depression) scores were calculated accordingly. Demographics, education and marital statuses of both the patients and their relatives were recorded. Logistic regression analysis was performed to determine the factors associated with depression and anxiety. Receiver operator characteristics (ROC) curves were drawn for the factors affecting depression and anxiety, and the area under the curve values were calculated. Results Demographics, APACHE II score, and patient affiliation were similar in both groups. The mean HADS scores of the relatives of COVID-19 and non-COVID-19 patients were 24.76 and 16.04 (p<0.001). The mean HADS-A scores were 12.89 and 7.78 (p<0.001), and the mean of HADS-D scores were 11.87 and 8.27 (p=0.001). Moderate and high-risk anxiety and depression were significantly higher in relatives of COVID-19 patients (p=0.018, p=0.001, respectively). The area under curve (AUC) values were 0.727 in the ROC curve plotted for the independent risk factor Q3 responses that reduced anxiety, and 0.791 and 0.785 in the ROC curve drawn for the independent risk factor Q1 and Q3 responses that reduced the development of depression. Conclusion We found that the anxiety and depression risk of the relatives of COVID-19 patients in the intensive care unit during the pandemic period is significantly higher than the relatives of non-COVID-19 patients in the intensive care unit. In addition, regardless of the diagnosis, younger intensive care patients may increase the anxiety and depression of the relatives of the patients during the pandemic. The higher-education level of the relatives of patients was determined as a factor reducing anxiety and depression.

Keywords: anxiety level; covid-19; depression; hospital anxiety depression scale (hads); intensive care unit; relative.