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08-12-2009 | Mental health | Article

Caregivers of BD patients show ill health and depression

Abstract

Free abstract

MedWire News: People who care for bipolar disorder (BD) patients with increasing suicidal ideation (SI) over time and depressive, rather than manic, symptoms are prone to suffering from depression and worsening health, show US researchers.

“Our study results may help to prospectively identify caregivers at risk for adverse health outcomes who may benefit from prevention-focused intervention,” say Cheryl Chessick (University of Colorado Denver School of Medicine) and co-authors.

For the study, the team evaluated 500 patients participating in the Systematic Treatment Enhancement Program for Bipolar Disorder – a multicenter study evaluating the course and outcome of patients with BD – and their primary caregivers (including 188 parental and 182 spousal) for up to 1 year.

Caregivers’ perceptions of their own physical health and depression were evaluated using the general health scale from the Medical Outcomes Study 36-item Short-Form Health Survey and the Center for Epidemiological Studies of Depression Scale, respectively.

After controlling for patient’s history of suicide attempts, education, baseline Global Assessment of Functioning scores, current alcohol or substance abuse, and living situation, higher SI scores at baseline and at 6 and 12 months were associated with lower caregiver health scores at all time points compared with patients who had lower SI scores at all times.

Furthermore, poorer caregiver health at 6 and 12 months was significantly associated with caring for patients who showed increased SI at 6 and/or 12 months compared with baseline. This association remained significant after controlling for confounding factors.

In contrast, patients’ depression scores at all time points were not significantly related to caregivers’ self-reported health. “Thus, SI appears to have contributed to caregivers’ health, whereas depression in the absence of SI did not,” remark the researchers.

Caregivers were more likely to have higher depression scores at all time points if they were caring for patients with higher SI at all follow-up points compared with caregivers of patients with lower SI, after controlling for confounding factors.

However, the increase in patients’ SI from baseline was not significantly associated with caregivers’ depression scores at 6 and 12 months after controlling for baseline caregivers’ depression and baseline patients’ SI.

Lastly, the researchers found that higher patient depression scores at all follow-up points were associated with higher caregiver depression scores after controlling for confounding factors.

Writing in the journal Bipolar Disorders, the team concludes: “Improving caregivers’ health may depend in some cases on fully stabilizing patients.”

They add: “Future research may be able to clarify why some caregivers are resilient even in the face of patients’ depression and SI.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Ingrid Grasmo

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