Study finds stress hormone may identify family members likely to suffer from anxiety after loved one’s hospitalization

When a loved one has been hospitalized in intensive care for a critical illness, many family members experience anxiety, depression, post-traumatic stress or other negative effects lasting months, according to new research led by Intermountain Medical Center.
The new research suggests that determining which family members are likely to suffer long-term effects could offer guidance to caregivers about how to help them.
The study is believed to be the first research of its kind to investigate the link between cortisol levels of family members of adult ICU patients and subsequent anxiety.
Participants in the study were family members of patients who’d been admitted to Intermountain Medical Center’s medical/surgical intensive care unit. Family members were followed by researchers for three months.
Three months after the patient was discharged, researchers found that 32 percent of the family members studied were anxious, 16 percent had symptoms of depression, and 15 percent reported signs of post-traumatic stress.
Researchers also found an increase of about 50 percent in family members’ cortisol levels after they woke up in the morning, which was associated with anxiety in family members three months after hospital discharge.
Cortisol is sometimes called the “stress hormone” because it can spike during periods of stress, such as when a loved one is critically ill. Unlike the surge in cortisol shortly after awakening, general cortisol levels weren’t found to predict long-term symptoms of mood disorders among participants in the study.          
Family members were studied because an ICU admission can affect the entire family. Family members experience new challenges, including caring for a loved one, learning details of providing medical care, and a reduction or break from employment.
“Family members need time to adjust to these new roles, situations and responsibilities,” said Ellie L. Hirshberg, MD, MS, a critical care physician at Intermountain Medical Center, who led the study, and who co-directs the Center for Humanizing Critical Care at the hospital.
“This study confirms the long-held belief that family members are experiencing stress during an ICU stay. This is important,” said Dr. Hirshberg. “The next step we hope to take in the future is to study support interventions that can reduce this stress and the associated anxiety, depression, and PTSD that may follow.”
Researchers targeted family members because they’re an important part of a patient’s recovery team and often have their own unmet needs. “There’s likely a link between family member wellness and a patient’s trajectory for recovery,” Dr. Hirshberg said.

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