Abstract
Background Family members providing continuous care to demented patients suffer from severe burden that impairs quality of life and often evolves to depression. Objective This study aims to evaluate the effect of psychodynamic group psychotherapy (PGT) compared to body awareness therapy (BAT) on caregiver burden, depressive symptoms, and quality of life among family caregivers to Alzheimer disease (AD) patients. Methods Thirty-seven healthy family caregivers were randomly allocated to receive PGT (n = 20) or BAT (n = 17). Interventions were administered in the format of 14 weekly group sessions. Outcome measures were: modification of scores on Zarit Burden Scale, Beck Depression Inventory and WHO-QoL Scale. Results Participants in the PGT group displayed significant reduction on burden (p = 0.01) and depression scores (p = 0.005), and improved quality of life (p = 0.002), whereas those in the BAT group showed improvements in burden of care (p = 0.001) and quality of life (p = 0.01), but not on depressive symptoms (p = 0.13). Discussion Psychodynamic psychotherapy was associated with amelioration of depressive symptoms, but overall benefits on burden of care and quality of life were similar irrespective of the type of intervention, i.e., psychologically-oriented or not. We hypothesize that these interventions can be complementary to improve depression and burden of care among family caregivers of AD patients.
Highlights
As a consequence of the increasing prevalence of Alzheimer disease (AD) worldwide in the last decades, the number of family caregivers has increased steadily, in settings where the access to professional caregiving is limited by financial or cultural reasons. This role is well accepted to bear a high-risk for the development of physical and mental health impairments, which are observed in a high proportion of caregivers. This is largely explained by the increased burden generated by the excess of work and responsibilities involved in caring for demented patients, in addition to the emotional implications of having a family member with declining cognitive skills and functional autonomy, in addition to an array of behavioral problems
Repeated measure analysis of variance showed that there was a significant improvement in depressive symptoms in the whole sample, regardless of the intervention group (within-subject contrast: F(1,35) = 19.95, p < 0.001; group*factor interaction: F(1,35) = 0.43, p = 0.51)
Our results suggest that both interventions were effective reducing the magnitude of caregiver burden and resulted in a better perception of quality of live, but only participants who received psychodynamic group therapy (PGT) experienced a reduction in depressive symptoms
Summary
As a consequence of the increasing prevalence of Alzheimer disease (AD) worldwide in the last decades, the number of family caregivers has increased steadily, in settings where the access to professional caregiving is limited by financial or cultural reasons This role is well accepted to bear a high-risk for the development of physical and mental health impairments, which are observed in a high proportion of caregivers. Discussion: Psychodynamic psychotherapy was associated with amelioration of depressive symptoms, but overall benefits on burden of care and quality of life were similar irrespective of the type of intervention, i.e., psychologically-oriented or not We hypothesize that these interventions can be complementary to improve depression and burden of care among family caregivers of AD patients
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