Abstract
BackgroundCaregiving in depression imposes a complex health and economic burden. Moreover, there is a paucity of studies examining the impact of caregiving for adult relatives with unipolar depression (CG-UD). This study assessed the burden among CG-UD in five western European (EUR5) countries (France, Germany, Italy, Spain and the United Kingdom) compared with caregivers of adults with other chronic comorbidities (CG-OD) and general non-caregiving (non-CG) population.MethodsA retrospective observational study was conducted using the 2016 National Health and Wellness Survey (NHWS) in EUR5. Differences in humanistic burden (health status and health-related quality of life [HRQoL]) and economic burden (work productivity and activity impairments, health care resource utilization [HRU]) were assessed between CG-UD and CG-OD respondents. Caregiver-specific burden (caregiving responsibilities and caregiver reaction assessment [CRA]) was assessed between caregiver groups. Generalized linear models were used to compare between the groups on the outcomes after adjusting for potential confounders.ResultsOf the 77,418 survey respondents examined, 1380 identified as CG-UD, 6470 as CG-OD and 69,334 as non-CG. Compared to CG-OD and non-CG, CG-UD, reported significantly lower health status (e.g., EuroQoL-5 Dimensions-5 Levels [EQ-5D-5L]: CG-UD = 0.63, CG-OD = 0.67, and non-CG = 0.73, p < 0.001) and HRQoL (e.g., mental component score: CG-UD = 35.0, CG-OD = 37.8, and non-CG = 40.7, p < 0.001). Although effect sizes were small (d < 0.2), minimal clinically important differences (MCID) were apparent for HRQoL and health status. Increased economic-related burden was observed for work and activity impairment (e.g., absenteeism: CG-UD = 32.6%, CG-OD = 26.5%, and non-CG = 14.8%, p < 0.001) and HRU (e.g., healthcare provider [HCP; mean, past 6 months]: CG-UD = 10.5, CG-OD = 8.6, and non-CG = 6.8, p < 0.001). Caregiving-specific burden was associated with experiencing a greater lack of family support (CG-UD: 2.9 vs CG-OD: 2.8, p < 0.01), impact on finances (CG-UD: 3.0 vs CG-OD: 2.9, p = 0.036), and on the caregiver’s schedule (CG-UD: 3.1 vs CG-OD: 3.0, p = 0.048).ConclusionCaregivers of persons with chronic disease experience an excess humanistic and economic burden compared to the general population, with a greater burden confronting caregiver for adults with depression. These findings illustrate the far-reaching burden of depression on both the patient and the relatives who care for them.
Highlights
Caregiving in depression imposes a complex health and economic burden
The Global Burden of Disease Study (GBDS) 2017 reported depression as the third leading cause of years lived with a disability (YLD) worldwide [2]
The study showed an association between these changes and patients with treatment resistant depression (TRD)-nonremission after treatment, highlighting the influence that the significant burden experienced by caregivers can have on the progression of disease and the treatment outcome of the patient with TRD [15]
Summary
Caregiving in depression imposes a complex health and economic burden. there is a paucity of studies examining the impact of caregiving for adult relatives with unipolar depression (CG-UD). The Global Burden of Disease Study (GBDS) 2017 reported depression as the third leading cause of years lived with a disability (YLD) worldwide [2]. Depression is associated with significant humanistic and economic burden, [3] affecting quality of life, daily activities as well as increasing medical and healthcare costs [4,5,6,7,8,9]. In a study on caregivers of depression, close to half of the caregivers experienced moderate to severe burden, as quantified by the Zarit Burden Interview and General Health Questionnaire [14]. A case-control study by Rane et al (2012) reported that carers of patients with treatment resistant depression (TRD) experienced increased levels of psychological distress and burden that resulted in adverse psychological and physiological changes, manifested as decreased cortisol levels after awakening which is a stress indicator. According to European Quality of Life Survey 2016, all caregivers, unemployed caregivers, report poorer health and lower life satisfaction [16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
