Coping and distress in caregivers of patients with disorders of consciousness

Objectives: To study depression, anxiety, maladjustment and coping in caregivers of patients in vegetative state (VS) or minimally conscious state (MCS). Materials and methods: Fifty-three caregivers of 43 patients with VS or MCS were assessed using Beck Anxiety Inventory, Beck Depression Inventory, maladjustment scale and Brief Coping Orientation of Problems Experienced (COPE-28). Results: There were 15 clinical cases (cut-off >= 21) of anxiety (28.30%); 16 cases (cut-off >= 21) of depression (30.20%); and 45 cases (cut-off >= 12) of maladjustment (84.8%). Active and problem-focused (Active coping, Instrumental support, Planning and Acceptance) were the most frequently used coping strategies. Acceptance predicted the absence of depression (p = 0.000, Cohen's d = 1.08) and anxiety (p = 0.000, Cohen's d = 1.08). Denial was associated with depression (p = 0.000, Cohen's d = 1.65) and anxiety (p = 0.000, Cohen's d = 1.23). Self-blame was associated with greater anxiety (p = 0.001, Cohen's d = 1.06) and depression (p = 0.001, Cohen's d = 1.07). Emotion-focused coping was associated with anxiety (p = 0.000, Cohen's d = 1.29) and depression (p = 0.001, Cohen's d = 1.11). Conclusions: Caregivers of patients with VS or MCS presented high levels of distress. Psychological support for caregivers of patients with VS or MCS is necessary. The most frequently used coping strategies were Active and Problem-focused. Acceptance was highly protective, but Denial, Self-blame and Emotion-focused strategies were very negative.