BMJ 1996;312:153-156 (20 January)

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Depression and other psychiatric morbidity in carers of elderly people living at home

Gill Livingston, senior lecturer in psychiatry,a Monica Manela, research assistant,a Cornelius Katona, professor of psychiatry of the elderly a

a Department of Psychiatry, University College London Medical School, London W1N 8AA

Correspondence to: Dr Livingston.

Abstract

Objective: To describe the mental health of a community sample of carers of elderly people with dementia, depression, or physical disability and to compare that with the mental health of other adults living in the household and of those living alone.
Design: Assessment of psychiatric morbidity and physical disability with standardised questionnaire in randomly selected enumeration districts; subjects were interviewed at home.
Setting: London Borough of Islington.
Subjects: 700 people aged >/=65 and other coresidents.
Main outcome measure: Depression measured with standardised interview.
Results: The prevalence of depression was not significantly higher in carers overall (15%) than in coresidents (11%). Being a woman carer was a significant predictor of psychiatric illness. Depression was more common in the carers of people with a psychiatric disorder than in coresidents (24% v 11%, P<0.05) and in those living alone (19%). Depression was most common (47%) in women carers of people with dementia.
Conclusion: The increase in psychiatric morbidity reported in carers of people with psychiatric disorders may reflect the lack of a confiding relationship.

Key messages

  • Key messages

  • Although in clinical practice carers seem psychologically vulnerable, studies of representative community samples provide little evidence to support this

  • This study shows that being a carer of an older person is not in itself a risk factor for psychiatric illness or for important psychological symptoms

  • Carers of older people with psychiatric disorders (particularly women carers of people with dementia) have an increased risk of depression

  • Increased psychiatric morbidity in carers of people with psychiatric (rather than physical) illness may be mediated by the lack of a confiding relationship


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