Evaluating Somatization, Depression, Anxiety and Health Anxiety Symptoms in Caregivers of COVID-19 Inpatients

Symptoms in caregivers of COVID-19 inpatients

Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease with no definite treatment; delayed intervention can increase mortality risk. These factors can have a significant impact on psychological health. This study aimed to evaluate somatization, depression, anxiety, and health anxiety symptoms in caregivers of COVID-19 inpatients.

Methods: This cohort study was conducted in Al-Zahra and Khorshid hospitals, COVID-19 centers in Isfahan, Iran, from February 2021 to August 2021. Ninety caregivers of COVID-19 inpatients participated in the study group and ninety of their relatives in the control group. Three standard questionnaires were used: the Patient Health Questionnaire (PHQ) to assess somatic symptom severity, the Depression, Anxiety, and Stress Scale (DASS) to evaluate main symptoms of depression, anxiety, and stress, and the Short Health Anxiety Inventory (HAI) to assess health anxiety. Caregivers completed these questionnaires at the time of hospital admission, immediately after patient discharge/death, and one month later. The control group completed the questionnaires once during the study period. All statistical analyses were performed using SPSS software, and a significance level of P < 0.05 was considered statistically significant. To compare the mean scores of all questionnaires in caregivers with the control group, the generalized linear model (GLM) was employed. On two groups of caregivers based on their patient outcome (death/discharge) and depending on the normality of the mean score distribution, the Mann-Whitney U test or the independent t-test was used to compare the mean scores of all questionnaires between these two caregiver groups.

Results: There were no significant differences in mean scores of the three questionnaires between the control group and caregivers at baseline. Health anxiety levels increased in caregivers following patient death (P = 0.003), both immediately after and one month later (P = 0.001). The death of a patient significantly increased somatization in their caregivers (P = 0.003), and this score did not decrease after one month of follow-up. There was a significant magnitude of change in depression (P = 0.05) and anxiety (P = 0.03) among caregivers of deceased patients, and stress levels were significant in both groups of caregivers (P = 0.001 and P = 0.003).

Conclusion: Our analysis indicates that caregivers of COVID-19 inpatients, particularly those caring for deceased patients, should be considered high-risk cases for psychological problems.