46 CHAPTER 3 3.3.2 Mental wellbeing of patients and caregivers at 3 and 12-months after discharge The percentage of patients experiencing mental frailty, previously described as at least one clinically relevant psychiatric symptom, increased over time (25% vs 38%, p = 0.010, Figure 2). The increase was most prominently present in isolated or combined anxiety or depressive symptoms (13%–24%, p = 0.017, 17%–27%, p = 0.045). If patients experienced a combination of psychiatric symptoms, it was most often depression and anxiety at both time points (4% and 10%, respectively). A marginal proportion of patients with mental frailty experienced a combination of depression, anxiety, and trauma-related issues. Univariate analyses of patient mental health scores and caregiver strain indices singled out several differences between groups (Figure 3). At both time points, patients with mental frailty scored higher for anxiety, depression, and trauma symptoms. Caregivers of patients with mental frailty experienced higher strain and had more trauma-related complaints at 3 and 12-months. At 3-months, 20% of caregivers of patients with mental frailty experienced high levels of strain compared to 11% in the non-frail group (p = 0.042). This difference in caregiver strain was similar at 12-months post-ICU (22% vs 6%, p < 0.001). Moreover, absolute CSI-scores decreased over time in the non-frail group. In addition, caregivers of patients with worse mental health outcomes more often experienced above threshold trauma symptoms at 12-months (17% vs 3%, p < 0.001) (Supplemental File 1). Figure 2. Size-proportional Venn diagram of the presence of (a combination of) above threshold depressive symptoms (D, red), anxiety (A, green), or trauma (T, blue) in all patients at 3 and 12-months post-ICU in absolute numbers with significant increases indicated as * p≤0.05. 3 months post-ICU (n=59, 25%) 12 months post-ICU (n=90, 38%) D A A* T T D* 22 24 24 9 1 3 15 10 4 5 6 13 6 7
RkJQdWJsaXNoZXIy MjY0ODMw