Relationship of coping style to mood and anxiety disorders in dementia carers

Abstract

Mood and anxiety disorders are common in family carers of people with dementia, and are associated with poor carer and care recipient outcomes. Caring for someone with dementia is stressful, but how carers cope may be an important determinant of carer psychological morbidity. This review summarizes and integrates the literature on the effect of coping style and its role in effective carer interventions. Two systematic reviews evaluated relationships between coping style and mood/anxiety disorders in observational studies and randomized controlled trials (RCTs), respectively. Several subsequent cross-sectional studies have also investigated these relationships, including in the context of coping as a mediator or moderator. Studies also investigated suicidality and cultural factors underlying coping. More dysfunctional, and less emotional support and acceptance-based coping styles are robustly associated with carer depression and anxiety symptoms and caseness in cross-sectional studies. There is also preliminary evidence from longitudinal studies that these coping styles may predict subsequent carer psychological morbidity. Psychological interventions successful in reducing depression counterintuitively increased dysfunctional coping in RCTs, but no RCTs have directly tested whether emotional support and acceptance-based coping mediates the effects of psychological intervention.