Prevalence of caregiver burden, depressive and anxiety symptoms in caregivers of children with psychiatric disorders in Durban, South Africa

Abstract

BackgroundThere is increased caregiver burden, depressive and anxiety symptoms associated with the care of mentally ill children. This may be influenced by child or caregiver factors such as socio-demographic and clinical factors and has not been explored in the South African context.AimTo describe the prevalence of depression, anxiety symptoms and caregiver burden in caregivers of children treated at psychiatric outpatient services at two public sector hospitals.MethodsA cross-sectional questionnaire study of 121 adult primary caregivers of children aged 1–17 years with mental illness using a socio-demographic questionnaire, Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder-7 Questionnaire (GAD-7), and the Child and Adolescent Impact Assessment (CAIA) to assess caregiver burden.ResultsThe caregivers were predominantly female (n = 96, 79.5%) and married (n = 72, 59.5%), with a mean age of¬34.99 years (SD 10.38), and 74% were mothers. Among the children, there was a predominance of boys with a 1:4 ratio of girls to boys. The most common diagnoses in the children were attention deficit hyperactivity disorder (ADHD) (n = 56, 59.6%) and autism spectrum disorder (n = 22, 23.4%). Fifty-four (44%) caregivers were depressed with a mean PHQ9 score of 5.75 (SD 5.98), and 65 (54 %) reported anxiety symptoms with a mean GAD7 score of 5.71 (SD 5.03). Mothers reported significantly higher levels of anxiety (p = 0.045) and experienced higher impact on feelings of personal well-being on the CAIA (p = 0.004) in comparison with fathers. Caregiver burden was predominantly reported in the domains of restrictions in activities (n = 40, 32.8%), feelings of personal well-being (n = 37, 30.7%) and economic impact (n = 21, 17.4%).The caregivers of children with ADHD reported higher anxiety levels (p = 0.023) than for autistic children. A diagnosis of autistic spectrum disorder was associated with higher income impact (p = 0.004) and restrictions impact (p = 0.001) than for children with ADHD diagnosis in terms of caregiver burden.ConclusionThe high prevalence of depression and anxiety symptoms reported amongst caregivers suggests the need for improved mental health screening and psycho-social support programmes for caregivers, particularly mothers. Programmes should consider the impact of caregiving, particularly on mental health, income and social restrictions of caregivers.