Evidence map›Paper›PMID 41398289›Full record

ArticleJournal of intensive care2025

Anxiety, depression and distress in family members of people who have experienced a critical care admission: a systematic review and Bayesian meta-analysis.

P Hartley, C Brown, V Danesh, F Forsyth, K Bond, I Kuhn, M Shaw, J McPeake

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Article in Journal of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

P HartleyThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK. ph492@cam.ac.uk.
C BrownThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
V DaneshCenter for Applied Health Research, Baylor Scott & White Health, Dallas, TX, USA.
F ForsythPACE Section (Perioperative, Acute, Critical Care and Emergency Medicine), Department of Medicine, University of Cambridge, Cambridge, UK.
K BondDepartment of Physiotherapy, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
I KuhnMedical Library, University of Cambridge, Cambridge, UK.
M ShawSchool of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
J McPeakeThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.

Funding

NIHR Cambridge Biomedical Research Centre NIHR203312
6 · The paper itself

Abstract

backgroundFamily members of adults who experience a critical care admission often experience significant strain and emotional distress following discharge. This meta-analysis aimed to synthesise the levels of distress, anxiety, and depression in family members of people who have experienced a critical care admission.

methodsMedline, PsycINFO, Scopus, CINAHL and Web of Science databases were searched for articles (2000-2024) that measured distress using the Impact of Events Scale-Revised (IES-R), or anxiety or depression using the Hospital Anxiety and Depression Scale subscales (HADS-A and HADS-D) 3 months after critical care. Bayesian meta-analyses estimated the pooled average, and meta-regression examined whether the inclusion of bereaved relatives influenced the pooled outcome estimates. Anxiety and depression models estimated the pooled proportion of participants with HADS scores >7.

resultsFifty articles were included (45 cohorts). Seventeen studies were from the USA and the median sample size at baseline assessment was 94.0. The pooled estimate of the IES-R at 3 months was 18.16 points [95% credible interval (CrI): 12.26-26.23, 15 studies]. The pooled estimate of the HADS-A at 3 months was 5.98 points (CrI: 5.29-6.73, 35 studies). The estimated proportion of family members with clinically meaningful levels of anxiety (HADS-A > 7) was 0.38 (95% CrI: 0.30-0.47; 11 studies). The pooled estimate of the HADS-D at 3 months was 3.91 points (95% CrI: 3.39-4.50; 33 studies). The estimated proportion of family members with clinically meaningful levels of depression (HADS-D > 7) was 0.20 (95% CrI: 0.15-0.26; 11 studies). Meta-regression found no significant effect of including non-bereaved participants only with the HADS subscales and was not possible due to insufficient studies with the IES-R.

conclusionsLevels of distress, anxiety and depression appear to be comparable between individuals who experience a critical care admission and their family members. An estimated 38% and 20% of family members have clinically important levels of anxiety and depression, respectively. PROSPERO registration: CRD42022302735.

Indexed as

AnxietyBayesianCritical careDepressionFamilyMental healthMeta-analysisSystematic review

Identifiers

PMID41398289
PMCPMC12771835

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