Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-13T07:14:56.778Z Has data issue: false hasContentIssue false

Prevalence and predictors of major depressive disorder in bereaved caregivers at 6 and 13 months

Published online by Cambridge University Press:  28 May 2018

Seon-Young Kim*
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea Mental Health Clinic, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea
Seung-Jeon Kim
Affiliation:
Departments of Psychiatry, Dasarang Alcohol Hospital, Gwangju, Republic of Korea
Jae-Min Kim
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
Sung-Wan Kim
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
Il-Seon Shin
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
Hyun-Jeong Shim
Affiliation:
Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
Sang-Hee Cho
Affiliation:
Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
Ik-Joo Chung
Affiliation:
Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
Jin-Sang Yoon
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
*
Author for correspondence: Seon-Young Kim, Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-Ku, Gwangju 61469, Republic of Korea. E-mail: sykimpsy@chonnam.ac.kr

Abstract

Objective

Depressive symptoms are common in bereaved caregivers; however, there have been few prospective studies using a structured interview. This study investigated the prevalence and preloss predictors of major depressive disorder (MDD) in bereaved caregivers of patients in a palliative care unit.

Method

This prospective cohort study collected caregiver sociodemographic and psychological data before the death of a palliative care unit patient, including MDD, care-burden, coping style, and hopeful attitude. Postloss MDD was assessed 6 and 13 months after death, and a multivariate logistic regression analysis was conducted to identify its predictors.

Result

Of 305 caregivers contacted, 92 participated in this study. The prevalence of preloss MDD was 21.8%; the prevalences of postloss MDD were 34.8% and 24.7% at 6 and 13 months, respectively. Preloss MDD predicted postloss MDD at 6 months (odds ratio [OR] = 5.38, 95% confidence interval [CI95%] = 1.29, 22.43); preloss nonhopeful attitude and unemployment status of caregivers predicted postloss MDD at 13 months (OR = 8.77, CI95% = 1.87, 41.13 and OR = 7.10, CI95% = 1.28, 39.36, respectively).

Significance of results

Approximately 35% of caregivers suffered from MDD at 6 months postloss, but the prevalence of MDD decreased to about 25% at 13 months. Preloss MDD significantly predicted postloss MDD at 6 months, whereas hopeful attitude and unemployment at baseline were significantly associated with postloss MDD at 13 months.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aber, CS (1992) Spousal death, a threat to women's health: paid work as a “resistance resource.” Image—The Journal of Nursing Scholarship 24(2), 9599.10.1111/j.1547-5069.1992.tb00231.xGoogle Scholar
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th ed, text revision. Washington, DC: American Psychiatric Press.Google Scholar
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Press.Google Scholar
Allen, JY et al. (2013) Bereavement among hospice caregivers of cancer patients one year following loss: Predictors of grief, complicated grief, and symptoms of depression. Journal of Palliative Medicine 16(7), 745751.10.1089/jpm.2012.0450Google Scholar
Beck, AT et al. (1974) The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology 42(6), 861865.10.1037/h0037562Google Scholar
Breitbart, W et al. (2000) Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA 284(22), 29072911.10.1001/jama.284.22.2907Google Scholar
Cherlin, EJ et al. (2007) Bereavement services for family caregivers: How often used, why, and why not. Journal of Palliative Medicine 10(1), 148158.10.1089/jpm.2006.0108Google Scholar
Cho, MJ, Nam, JJ and Suh, GH (1998) Prevalence of symptoms of depression in a nationwide sample of Korean adults. Psychiatry Research 81(3), 341352.10.1016/S0165-1781(98)00122-XGoogle Scholar
Corden, A, Hirst, M and Nice, K (2008). Financial implications of death of a partner. Social Policy Research Unit: University of York, York, UK. Available from https://www.york.ac.uk/inst/spru/research/pdf/Bereavement.pdfGoogle Scholar
Fenix, JB et al. (2006) Religiousness and major depression among bereaved family caregivers: A 13-month follow-up study. Journal of Palliative Care 22(4), 286292.10.1177/082585970602200406Google Scholar
Garrido, MM and Prigerson, HG (2014) The end-of-life experience: Modifiable predictors of caregivers' bereavement adjustment. Cancer 120(6), 918925.10.1002/cncr.28495Google Scholar
Gort, AM et al. (2005) Short Zarit scale in palliative care. Medicina Clinica 124(17), 651653.10.1157/13074742Google Scholar
Große, J, Treml, J and Kersting, A (2018) Impact of caregiver burden on mental health in bereaved caregivers of cancer patients: A systematic review. Psychooncology 27(3), 757767.10.1002/pon.4529Google Scholar
Guldin, MB et al. (2012) Complicated grief and need for professional support in family caregivers of cancer patients in palliative care: a longitudinal cohort study. Supportive Care in Cancer 20(8), 16791685.Google Scholar
Jang, JE et al. (2013) Religiosity, depression, and quality of life in Korean patients with breast cancer: A 1-year prospective longitudinal study. Psychooncology 22(4), 922929.10.1002/pon.3083Google Scholar
Jho, HJ et al. (2016) Prevalence and associated factors of anxiety and depressive symptoms among bereaved family members of cancer patients in Korea: A nation-wide cross-sectional study. Medicine (Baltimore) 95(22), e3716.10.1097/MD.0000000000003716Google Scholar
Kim, SW et al. (2006) Correlates of caregiver burden for Korean elders according to cognitive and functional status. International Journal of Geriatric Psychiatry 21(9), 853861.10.1002/gps.1571Google Scholar
Kim, SY et al. (2014) Determinants of a hopeful attitude among family caregivers in a palliative care setting. General Hospital Psychiatry 36(2), 165171.10.1016/j.genhosppsych.2013.10.020Google Scholar
Kim, Y, Lucette, A and Loscalzo, M (2013). Bereavement needs of adults, children, and families after cancer. Cancer Journal 19(5), 444457.10.1097/PPO.0b013e3182a5babeGoogle Scholar
Kuo, SC et al. (2017). Longitudinal changes in and modifiable predictors of the prevalence of severe depressive symptoms for family caregivers of terminally ill cancer patients over the first two years of bereavement. Journal of Palliative Medicine 20(1), 1522.10.1089/jpm.2016.0116Google Scholar
Lin, N, Dean, A and Ensel, WM (1986) Social support, life events, and depression. New York: Academic Press.Google Scholar
Ling, SF et al. (2013) Trajectory and influencing factors of depressive symptoms in family caregivers before and after the death of terminally ill patients with cancer. Oncology Nursing Forum 40(1), E32E40.10.1188/13.ONF.E32-E40Google Scholar
Maciejewski, PK et al. (2007) An empirical examination of the stage theory of grief. JAMA 297(7), 716723.10.1001/jama.297.7.716Google Scholar
Nielsen, MK et al. (2017a) Predictors of Complicated Grief and Depression in Bereaved Caregivers: A Nationwide Prospective Cohort Study. Journal of Pain and Symptom Management 53(3), 540550.Google Scholar
Nielsen, MK et al. (2017b) Preloss grief in family caregivers during end-of-life cancer care: A nationwide population-based cohort study. Psychooncology 26(12), 20482056.10.1002/pon.4416Google Scholar
Park, JY (1995) A study on the relationship among character type A & B, ego-identity and stress coping (Dissertation: Graduate School of Sookmyung Women's University).Google Scholar
Pettersson, A et al. (2015) Which instruments to support diagnosis of depression have sufficient accuracy? A systematic review. Nordic Journal of Psychiatry 69(7), 497508.10.3109/08039488.2015.1008568Google Scholar
Roulston, A et al. (2017) Bereavement outcomes: A quantitative survey identifying risk factors in informal carers bereaved through cancer. Palliative Medicine 31(2), 162170.10.1177/0269216316649127Google Scholar
Rumpold, T et al. (2017) Hope as determinant for psychiatric morbidity in family caregivers of advanced cancer patients. Psychooncology 26(5), 672678.10.1002/pon.4205Google Scholar
Schrank, B, Stanghellini, G and Slade, M (2008) Hope in psychiatry: A review of the literature. Acta Psychiatrica Scandinavica 118(6), 421433.10.1111/j.1600-0447.2008.01271.xGoogle Scholar
Shear, MK et al. (2011) Complicated grief and related bereavement issues for DSM-5. Depression and Anxiety 28(2), 103117.10.1002/da.20780Google Scholar
Sheehan, DV et al. (1988) The mini-international neuropsychiatric interview (M.I.N.I): The development and validation of a structured diagnostic psychiatric interview for DSM-VI and ICD-10. Journal of Clinical Psychiatry 59(suppl. 20), 2233.Google Scholar
Shin, MS, Park, KW and Oh, KJ (1990) A study of suicidal ideation among high depression in CAPD patients 793 school students. Korean Journal of Clinical Psychology 9(1), 19.Google Scholar
Wakefield, JC, Schmitz, MF and Baer, JC (2011) Relation between duration and severity in bereavement-related depression. Acta Psychiatrica Scandinavica 124(6), 487494.10.1111/j.1600-0447.2011.01768.xGoogle Scholar
Williams, AL and McCorkle, R (2011) Cancer family caregivers during the palliative, hospice, and bereavement phases: a review of the descriptive psychosocial literature. Palliative and Supportive Care 9(3), 315325.Google Scholar
Zisook, S and Shuchter, SR (1991) Depression through the first year after the death of a spouse. American Journal of Psychiatry 148(10), 13461352.Google Scholar
Zisook, S et al. (2012) The bereavement exclusion and DSM-5. Depression and Anxiety 29(5), 425443.10.1002/da.21927Google Scholar
Supplementary material: File

Kim et al. supplementary material

Table S1

Download Kim et al. supplementary material(File)
File 17 KB