Depression, Anxiety and Stress on Caregivers of Persons with Dementia (CGPWD) in Hong Kong amid COVID-19 Pandemic

Abstract

Background: Coronavirus disease 2019 (COVID-19) contributed to increasing prevalence of depressive symptoms and other psychological repercussions, particularly in the disease population in Hong Kong. Nonetheless, the caregiver burden of caregivers of persons with dementia (CGPWD), has been under-investigated. Aims: This study examined the psychological impact and its correlates on the CGPWD in Hong Kong amid the COVID-19 outbreak. Methods: CGPWD referred from rehabilitation clinics and online seminar were used to recruit participants to complete an online questionnaire by the end of the second-wave of the COVID-19 outbreak (June 2021). To be eligible, either full-time or part-time CGPWD, aged 18 or above, can understand Cantonese, currently reside in Hong Kong and offering care to PWD for at least one year, were recruited. Those CGPWD diagnosed with any type of psychiatric disorder were excluded from this study. The Chinese Center for Epidemiologic Studies Depression Scale (CES-D), Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder (GAD-7), Zarit Burden Interview (ZBI-22), and Nonattachment Scale (NAS-7) were used to measure participants’ depression, perceived stress, anxiety symptoms, caregiver burden and wisdom in subjective feelings of internal stress. The modified Medical Outcomes Study Social Support Survey (mMOS-SS) and the SARS Appraisal Inventory (SAI) were also administered to measure participants’ perceived support and coping efficacy. Follow-up responses were gathered by the end of third-wave outbreak (October 2021). Results: A total of 51 CGPWD participated, of which, 33 (64.7%) suffered from probable depression (CES-D score ≥ 16). Participants also showed a significant increase in depression symptom scores at the three-month follow-up period (t = 2.25, p = 0.03). CGPWD with probable depression had less non-attachment awareness and higher scores in anxiety, stress, caregiving burden, and coronavirus impact (all p < 0.05) than those without. Conclusions: High prevalence of depressive symptoms was noted among our CGPWD sample and these symptoms seemed to worsen substantially. Contingent online mental health support should be prioritized to those CGPWD to reduce psychiatric morbidity and the global disease burden.

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“…The anxiety of family caregivers limits their capacity to help the patient and can also exacerbate the patient's anxiety [ 13 ]. Nonetheless, home caregivers of the COVID-19 patients are experiencing greater levels of stress, anxiety, and depression symptoms [ 14 , 15 ] for a variety of reasons, including the fear of infection or transmitting it to others, poor community and governmental support, lack of access to medical care, and stigma [ 16 ]. These family caregivers would also face critical challenges compared to other caregivers because of the limited training and resources at hand as well as their insufficient knowledge about this emergent disease [ 10 ].…”

Bilateral repetitive transcranial magnetic stimulation ameliorated sleep disorder and hypothalamic–pituitary–adrenal axis dysfunction in subjects with major depression

“…Major depressive disorder (MDD) is a disabling mental disorder characterized by depressed mood, loss of interest, and reduced drive, and it is the most prevalent, affecting approximately 15-17% of the population and showing a high suicide risk rate equivalent to around 15% (1). Recently, there have been lots of work testing the association between COVID-19 and depression in the global general populations and vulnerable subpopulations (2)(3)(4)(5). One study suggested that the COVID-19 pandemic accelerates the increase in depressive symptoms from 19.8% in the months prior to the pandemic to 40.4% during the pandemic (6).…”

Factor Analysis Affecting Degree of Depression in Family Caregivers of Patients with Spinal Cord Injury: A Cross-Sectional Pilot Study

“…This problem can lead to the dissolution of a family [ 10 ]. From this perspective, several existing studies have described the relationship between the care burden and depression of various types of family caregivers by using the Center for Epidemiology Studies Depression Scale (CES-D) [ 11 , 12 , 13 , 14 ].…”

“…Family-caregiver characteristics, such as perceptions of spousal relationships, health problems, and care time and cost, were associated with depression [ 13 ]. In a study of 51 caregivers of dementia patients, approximately 64.7% of participants showed depressive symptoms (CES-D score ≥ 16), and these symptoms increased significantly during the 3-month follow-up period [ 14 ]. A study on the depression of caregivers of stroke survivors demonstrated that the relationship with the patient, the burden of “care”, and depression had a significant effect on their quality of life [ 11 ].…”