• Stephana J Cherak, Brianna K Rosgen, Mungunzul Amarbayan, Krista Wollny, Christopher J Doig, Scott B Patten, Henry T Stelfox, and Kirsten M Fiest.
• Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
• Crit. Care Med. 2021 Sep 1; 49 (9): 141414261414-1426.

ObjectivesDetermine effect of mental health interventions on psychologic outcomes in informal caregivers of critically ill patients.Data SourcesSearches conducted in MEDLINE, Embase, and other databases from inception to October 31, 2019.Study SelectionInterventions for informal caregivers of critically ill patients in adult ICU, PICU, or neonatal ICU.Data ExtractionTwo independent, blinded reviewers screened citations and extracted data. Random-effects models with inverse variance weighting pooled outcome data when suitable. Psychologic outcomes categorized: 1) negative (anxiety, depression, post-traumatic stress disorder, distress, and burden) or 2) positive (courage, humanity, justice, transcendence, temperance, and wisdom and knowledge). Stratification according to intervention type and patient population was performed.Data SynthesisOf 11,201 studies, 102 interventional trials were included (n = 12,676 informal caregivers). Interventions targeted caregiver experience (n = 58), role (n = 6), or support (n = 38). Meta-analysis (56 randomized controlled trials; n = 22 [39%] in adult ICUs; n = 34 [61%] in neonatal ICU or PICU) demonstrated reduced anxiety (ratio of means = 0.92; 95% CI, 0.87-0.97) and depression (ratio of means = 0.83; 95% CI, 0.69-0.99), but not post-traumatic stress disorder (ratio of means = 0.91; 95% CI, 0.80-1.04) or distress (ratio of means = 1.01; 95% CI, 0.95-1.07) among informal caregivers randomized to mental health interventions compared with controls within 3 months post-ICU discharge. Increased humanity (ratio of means = 1.11; 95% CI, 1.07-1.15), transcendence (ratio of means = 1.11; 95% CI, 1.07-1.15), and caregiver burden (ratio of means = 1.08; 95% CI, 1.05-1.12) were observed. No significant effects of mental health interventions observed after 3 months postdischarge.ConclusionsMental health interventions for caregivers of critically ill patients improved short-term anxiety, depression, humanity, and transcendence while increasing burden. Clinicians should consider short-term prescriptions of mental health interventions to informal caregivers of critically ill patients with capacity to manage interventions.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.

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