Psychiatric and Physical Morbidity Effects of Caregiving

Abstract

Existing empirical literature on the prolonged or cumulative consequences of exposure to the stresses of caregiving is reviewed. Specific goals are to identify psychiatric and physical morbidity effects, report the magnitude of those effects, evaluate research and analytic methods used to assess morbidity, and make recommendations for future research. Overall, the literature indicates increases in self-report psychiatric symptomatology and increases in psychiatric illness among most caregivers when compared to population norms or appropriate control groups. However, there is little information on the population prevalence or incidence of clinically significant psychiatric conditions attributable to caregiving. Studies of physical health effects as assessed by self-report, health care utilization, and immune function are less conclusive but, nevertheless, suggest increased vulnerability to physical illness among caregivers. We conclude with a discussion of why morbidity effects are difficult to obtain in caregiver studies and with recommendations for future research.

Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairment

“…Specifically, while mean levels of depressive and anxiety symptoms were lower than the typical levels observed in dementia caregivers (e.g. CES-D scores from 14 to 16, Schulz et al, 1990;Baumgarten et al, 1992;Schulz et al, 1995;Wijeratne, 1997), they were only slightly higher than levels seen in healthy non-caregiving elderly cohorts (e.g. CES-D scores from 7.4 to 9.4, Blazer et al, 1991).…”

Beyond Money: Toward an Economy of Well-Being

“…3 A significant amount of family suffering also occurs because of mental disorders. Schulz, Visintainer, and Williamson (1990) reviewed evidence showing that the cumulative effects of caring for someone with mental illness increase the caregiver's chances for a psychological disorder, as well as physical illness. Martens and Addington (2001) found that family members are stressed substantially by having to care for a relative with schizophrenia.…”

A Comparison of Psychosocial Outcomes in Elderly Alzheimer Caregivers and Noncaregivers

“…However, a large body of literature suggests that the chronic stress associated with providing care to a loved one with AD can have a deleterious impact on physical and mental health. Indeed, caregiving has been associated with increased risk for illnesses and diseases(7) such as coronary heart disease(8, 9). …”

“…Schubert and colleagues(11)found that over a 6-month period, 24% of dementia caregivers had an emergency department visit or hospitalization, with depressed caregivers being at greatest risk. Perhaps the increased rate of service utilization among caregivers is due to increased mental and physical health morbidity, including increased risk of mortality compared to non-caregivers (12)and high rates of psychiatric problems including depression and anxiety (7, 13). For example, Dura and colleagues report that dementia caregivers are significantly more likely to have a depressive disorder compared to demographically matched non-caregivers (14).…”