OBJECTIVES: Caregiving is related to poor mental health, especially for family caregivers. Social determinants of health (SDOH) affect this relationship, whereby younger caregivers report poorer mental health than their non-caregiving peers, while female caregivers report higher rates of depression than male caregivers. The objective of this study is to identify the differential burden of depression and anxiety among caregivers of adult family members (CG) with mental health/neurological disorders (CGMHND) compared to CG having other chronic diseases/conditions (CGO), stratifying by SDOH.

METHODS: Data from the 2018 US National Health and Wellness Survey were analyzed. Respondents caring for persons with Bipolar Disorder, Depression, Schizophrenia, Alzheimer’s Disease, Dementia, Parkinson’s Disease, Autism, or Epilepsy were classified CGMHND. Self-reported physician-diagnosis and current experience (Dx-CE) of depression, anxiety, and concomitant depression and anxiety (DPAX) were examined. Symptom severity was assessed for depression (Patient Health Questionnaire-9 [PHQ-9]; severe=PHQ-9>14) and anxiety (Generalized Anxiety Disorder-7 [GAD-7]; severe=GAD-7>14). Bivariate comparisons used chi-square tests.

RESULTS: Approximately half (55.5%, N=4942/8903) of CG were CGMHND. CGMHND reported higher rates of Dx-CE than CGO for depression (33.2% versus 18.8%), anxiety (34.2% versus 21.5%), and DPAX (24.8% versus 13.0%) (all p<0.001). Regardless of patient type, rates of Dx-CE of depression, anxiety, or DPAX were higher among younger and/or female caregivers (p<0.001). Among CGMHND with Dx-CE, rates of severe symptoms were higher among 18-29-year-olds compared to all other age groups (depression: 48.9% versus 22.6%; anxiety: 32.1% versus 12.9%; DPAX: 29.2% versus 12.7%; all p<0.001); however, with no significant difference by sex at p>0.05.

CONCLUSIONS: Younger, female CGMHND reported the highest rates of diagnosis for depression and/or anxiety. Younger CGMHND with Dx-CE reported the highest rates of severe symptoms for depression and/or anxiety. Interventions which target these specific at-risk segments have the potential to improve mental health for the caregiving population.