Abstract
PurposeThis study was designed to assess the effects of epilepsy severity, family resilience, and social support on depression in primary caregivers of children with epilepsy (CWE), and to test the mediating roles of family resilience and social support in this relationship.MethodTwo hundred fifty-two caregivers of children with epilepsy were recruited from October 2020 to May 2021. The questionnaire contained sociodemographic characteristics, Epilepsy Severity, Chinese-Family Resilience Assessment Scale (C-FRAS), Social Support Rating Scale (SSRS), Beck Depression Inventory (BDI). Structural equation models were used to evaluate whether family resilience and social support as mediators between epilepsy severity and depression.ResultsIn this study, the prevalence of depressive symptoms among primary caregivers of CWE in China was 69.84%. Epilepsy severity was positively associated with depression. Family resilience and social support were negatively correlated with depressive symptoms (both p < 0.01). Furthermore, the fitness indices of structural models were satisfactory. The direct effect of epilepsy severity on depression was 0.266 (95% CI 0.064–0.458), this pathway explained 62.88% variance of depression. The indirect effect of family resilience and then social support was 0.069 (95% CI 0.025–0.176), indicating that the serial multiple mediation was significant. The serial mediation pathway explained 16.31% variance of depression.ConclusionsThe high incidence of depression among primary carers of CWE deserves more attention. They should be screened routinely, especially those parents of children with severe epilepsy. Family resilience and social support could be protective factors for caregivers' mental adjustment. Therefore, future psychosocial interventions for enhancing family resilience and social support should be implemented, in order to reduce their depression.
Highlights
Epilepsy is one of the most common chronic neurological disorders in children, which is characterized by recurrent seizures caused by abnormal brain discharge
We developed a multiple-mediation model between epilepsy severity and caregivers’ depression to investigate the protective roles of family resilience and social support against negative effects on caregivers’ psychological adjustment
It corroborated that family resilience and social support could reduce the risk for depression
Summary
Epilepsy is one of the most common chronic neurological disorders in children, which is characterized by recurrent seizures caused by abnormal brain discharge. Parents often function as children’s main caregivers especially for families of CWE in China, they have to deal with these challenges, as well as face high medical costs, stigma from relatives and friends, limited family social interaction, and negative emotional reactions [6, 7]. As Reilly et al [8] indicated the prevalence of depression in mothers and fathers was 55 and 33%, compared with 27 and 31% correspondingly in the non-epilepsy-related neuro disability group. In China, the risk of depression was higher in parents of CWE compared with healthy children (23.51 vs 10.84%, p < 0.01) [9]. This psychological distress has been reported to be linked with an increased risk of depression in children, lower health-related quality of CWE, and decreased family function [10–12]. It is of vital importance to screen the psychological distress among caregivers of CWE and explore its comprehensive influencing factors for providing interventional strategies
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