Relationship between emotional distress in caregivers and health status in persons with multiple sclerosis

Abstract

Caregivers of persons with multiple sclerosis (MS) exhibit less satisfaction with quality of life with respect to the general population. To assess the relationship between depression in caregivers and health status profiles of MS patients, we examined data from 133 patients and their respective caregivers, as a part of a prospective randomized trial aimed to investigate the effectiveness of home-based care. Patients were evaluated at baseline and one year later with measures of physical and psychological impairment and health status (SF-36 Health Survey). Caregivers’ psychological morbidity was assessed by the Profile of Mood State (POMS) at the same time points. An improvement of patients’ health status as measured in four out of eight SF-36 dimensions was observed over the study period, while psychological morbidity of their caregivers did not change significantly. Depression in caregivers was related to physical, emotional and health status of the patients at baseline and/or at 12-month follow-up. Changes in the degree of depression of caregivers were also associated with changes in disability and health status of the patients. This study confirms and extends in a home-care setting previous findings on relationships between patients’ status and depression in caregivers. It suggests that the caregiver is an appropriate and independent target for more focused therapeutic strategies.

Keywords

caregiver depression health status home-care multiple sclerosis

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References

Aronson KJ. Quality of life among persons with multiple sclerosis and their caregivers . Neurology 1997; 48: 74-80 .

Carton H , Loos R , Pacolet J , Versieck K , Vlietinck R. A quantitative study of unpaid caregiving in multiple sclerosis . Mult Scler 2000; 6: 274-279 .

Aronson KJ , Cleghorn G , Goldenberg E. Assistance arrangements and use of services among persons with multiple sclerosis and their caregivers . Disabil Rehabil 1996; 18: 354-361 .

Knight RG , Devereux RC , Godfrey HP. Psychosocial consequences of caring for a spouse with multiple sclerosis . Clin Exp Neuropsychol 1997; 19: 7-19 .

Chipchase SY , Lincoln NB. Factors associated with career strain in carers of people with multiple sclerosis . Disabil Rehabil 2001; 23: 768-776 .

Pozzilli C , Brunetti M , Amicosante AM , Gasperini C , Ristori G , Palmisano L et al. Home-based management is beneficial and cost effective in multiple sclerosis. Results of a randomised controlled trial . J Neurol Neurosurg Psychiatry 2002; 73: 250-255 .

Poser CM , Paty DW , Scheinberg L , McDonald WI , Davis FA , Ebers GC et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols . Ann Neurol 1983; 13: 227-231 .

Kurtzke J. Rating neurological impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS) . Neurology 1983; 33: 1444-1452 .

Folstein M , Folstein S , McHugh PR. Mini mental state: a practical method of grading the cognitive state of patients for the clinicians . J Psychiatry Res 1975; 12: 189-198 .

10.

Kidd D , Stewart G , Baldry J , Johnson J , Rossiter D , Petruckevitch A et al. The Functional Independence Measure: a comparative validity and reliability study . Disabil Rehabil 1995; 17: 10-14 .

11.

Krupp LB , La Rocca NC , Muir-Nash J , Steinberg AD. The Fatigue Severity Scale applied to patients with multiple sclerosis and systemic lupus erithematosus . Arch Neurol 1989; 46: 1121-1123 .

12.

Spielberger CD , Vagg PR , Barker LR. The factor structure of State-Trait Anxiety Inventory. In Saranson IG , Spielberger CD eds. Stress and anxiety, Volume 7. New York, NY: Hemisfere/Wiley , 1980.

13.

Krugg SE , Scheier JH , Cattell RB. Handbook for the IPAT anxiety scale. Champaign, IL: IPAT , 1976.

14.

Ware JE , Sherbourne CD. The MOS-36 item short-form healthy survey (SF-36): conceptual framework and item selection . Med Care 1992; 30: 473-483 .

15.

Ware JE , Kosinki M , Keller SD. SF-36 physical and mental health summary scales: a user’s manual. Boston, MA: The Health Institute, New England Medical Center , December, 1994.

16.

McNair DM , Lorr M , Dropleman LF. Edits manual for the profile of mood states. San Diego, CA: Educational and Industrial Testing Service , 1992.

17.

Stommel M , Given CW , Given BA. Depression as an overriding variable explaining caregiver burdens . J Aging Health 1990; 2: 81-102 .

18.

Brodaty H , Gresham M. The effect of a training programme to reduce stress in carers of patients with dementia . BMJ 1989; 299: 1375-1379 .

19.

Mittelman MS , Ferris SH , Shulman E , Steinberg G , Ambinder A , Mackell JA et al. A comprehensive support programme: effect on depression in spouse caregivers of Alzheimer’s disease patients . Gerontologist 1995; 35: 792-802 .

20.

Marriott A. Effectiveness of cognitive-behavioural family intervention in reducing the burden of care in carers of patients with Alzheimer’s disease . Br J Psychiatry 2000; 176: 557-562 .