Family Functioning Is Associated With Depressive Symptoms in Caregivers of Acute Stroke Survivors
Presented as an abstract to the American Association for Geriatric Psychiatrists, February 23, 2004, Baltimore, MD.
Abstract
Epstein-Lubow GP, Beevers CG, Bishop DS, Miller IW. Family functioning is associated with depressive symptoms in caregivers of acute stroke survivors.
Objective
To determine whether family functioning is uniquely associated with caregiver depressive symptoms in the immediate aftermath of stroke.
Design
Cross-sectional data from the baseline assessment of an intervention study for stroke survivors and their families.
Setting
Neurology inpatient service of a large urban hospital.
Participants
Stroke survivors (n=192), each with a primary caregiver. The mean age of stroke survivors was 66 years, and most, 57%, were men (n=110). The mean age of caregivers was 57 years, and 73% (n=140) of the caregivers were women. Eighty-five percent of caregivers were white.
Interventions
Not applicable.
Main Outcome Measures
Measures were chosen to assess caregivers' depressive symptoms (Centers for Epidemiologic Studies Depression Scale), family functioning (Family Assessment Device), and additional factors such as health status (Medical Outcomes Study 36-Item Short-Form Health Survey) and stroke survivors' cognitive abilities (modified Mini-Mental State Examination) and functional impairments (FIM and Frenchay Activities Index).
Results
Depressive symptoms were mild to moderate in 14% and severe in 27% of caregivers. Family functioning was assessed as unhealthy in 34% of caregiver-patient dyads. In statistical regression models, caregiver depression was associated with patients' sex, caregivers' general health, and family functioning.
Conclusions
Forty-one percent of caregivers experienced prominent depressive symptoms after their family member's stroke. Higher depression severity in caregivers was associated with caring for a man, and having worse health and poor family functioning. After stroke, the assessment of caregivers' health and family functioning may help determine which caregivers are most at risk for a depressive syndrome.
aDepartment of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI
bPsychosocial Research Program, Butler Hospital, Providence, RI
cDepartment of Psychiatry, Rhode Island Hospital, Providence, RI
Reprint requests to Gary P. Epstein-Lubow, MD, Psychosocial Research Program, Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906
Supported by the National Institutes of Health (grant no. R01 NS37840).
A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit on the author or one or more of the authors. Gary P. Epstein-Lubow, MD, was a consultant for Forest Research Institute for a portion of the time while conducting these analyses.
ABSTRACT