Abstract
Coronavirus disease 2019 (COVID-19) is likely to exacerbate the symptoms of poor mental health in family caregivers. To investigate whether rates of depressive symptomatology increased in caregivers during COVID-19 and whether the unintended consequences of health protective measures, i.e., social isolation, exacerbated this risk. Another aim was to see if caregivers accessed any online/phone psychological support during COVID. Data (1349 caregivers; 6178 non-caregivers) was extracted from Understanding Society, a UK population-level data-set. The General Health Questionnaire cut-off scores identified those who are likely to have depression. After adjustment for confounding caregivers had a higher risk of having depressive symptoms compared with non-caregivers, odds ratio (OR) = 1.22 (95% CI 1.05-1.40, P = 0.008) evidenced by higher levels of depression pre-COVID-19 (16.7% caregivers v. 12.1% non-caregivers) and during the COVID-19 pandemic (21.6% caregivers v. 17.9% non-caregivers), respectively. Further, higher levels of loneliness increased the risk of depression symptoms almost four-fold in caregivers, OR = 3.85 (95% 95% CI 3.08-4.85, P < 0.001), whereas accessing therapy attenuated the risk of depression (43%). A total of 60% of caregivers with depression symptoms reported not accessing any therapeutic support (for example online or face to face) during the COVID-19 pandemic. COVID-19 has had a negative impact on family caregivers' mental health with loneliness a significant contributor to depressive symptomatology. However, despite these detriments in mental health, the majority of caregivers do not access any online or phone psychiatric support. Finally, psychiatric services and healthcare professionals should aim to focus on reducing feelings of loneliness to support at-risk caregivers.
Highlights
Coronavirus disease 2019 (COVID-19) is likely to exacerbate the symptoms of poor mental health in family caregivers
The present longitudinal case–control population-level study presented in this paper explores changes in levels of depression, a common marker of carer-related psychological morbidity, and other potential contributory factors, in family caregivers and non-caregivers assessed pre-COVID-19 and during the COVID-19 pandemic
Confounding variables were entered in step one of the model and caregiver groups entered at step two. This was followed by another logistic regression analysis for caregivers only, to examine the predictors of likely depression risk with the same confounding factors entered in step one, pre-COVID depression symptoms and loneliness at step two, and current COVID-19-related loneliness, access to treatment and more or less caring during the crisis in step three
Summary
The coronavirus disease 2019 (COVID-19) pandemic has obvious widespread effects on physical health; as the pandemic continues, there is an increasing and significant impact upon mental health.[1] For example, a recent-meta-analysis has found evidence of higher rates of depression in front-line workers during the pandemic relative to non-pandemic population norms.[2] Wide-scale public health interventions have been implemented internationally to contain the COVID-19 outbreak (for example school and business closures, physical distancing measures, quarantine, shielding or cocooning of at-risk individuals (shielding/cocooning are concepts used in the UK and Ireland to describe social isolation procedure instructions to protect the medically vulnerable from COVID-19)), alongside curtailment of many health and social non-emergency services These inventions are likely to have unintended consequences, especially for those who are vulnerable psychiatrically. Gallagher & Wetherell as these may reduce their vulnerability and inform future practice and treatment.[3]
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