Anxiety, Depression and Bereavement Adjustment: A Prospective Study of Informal Caregivers of Terminal Cancer...

Informal caregivers of patients with terminal cancer can experience an emotionally difficult time in the final stages of their caregiving journey with implications on their bereavement experience. The current study examined anxiety and depression among caregivers of terminal cancer patients and subsequent bereavement adjustment.

Caregivers from the Singapore COMPASS cohort study (N = 192) were prospectively followed from 6-month pre- to 6-month post-patient death. Multinomial and logistic regression models were performed to examine factors associated with anxiety, depression and complicated grief that may be targets for intervention.

Rates of anxiety and depression significantly increased closer to patient death (Anxiety: 47%-61%; Depression: 31%-42%) before decreasing 6-month post-patient death (Anxiety: 21%, Depression: 24%). 16% of caregivers reported persistent anxiety and 15% reported persistent depression from 6-month pre- to 6-month post-patient death, which were associated with the following pre-death caregiver factors: poorer physical health and high caregiving burden impacting their schedule and health. 33% of caregivers reported sub-threshold/likely complicated grief, which was associated with close caregiver-patient relationship, caregiver anxiety or depression at pre-patient death and greater perceived patient suffering.

Efforts to identify and support caregivers pre- and post-patient death are important to mitigate psychological sequalae.