Prevalence of anxiety and depressive disorders among informal caregivers of patients attending the Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria

Abstract

Background : Studies on the informal caregivers of the mentally-ill in Europe and America have revealed a high prevalence rate of anxiety and depressive disorders among this group when compared with controls. There is a dearth of studies on the effect of the caregiving role on informal caregivers in Nigeria. Aims : The aim of the study was to compare the prevalence of anxiety disorders and depression among informal caregivers of mentally-ill patients attending the Federal Neuropsychiatric Hospital Yaba, Lagos, Nigeria with that of a noncaregiving population. Methods : The self-administered questionnaire consisted of the sociodemographic data and the two screening instruments - the General Health Questionnaire-28 (GHQ-28) and the Hospital Anxiety and Depression Scale (HADS). An interview was carried out thereafter using the Present State Examination (PSE) to obtain an ICD-10 diagnosis from those subjects who scored above the cut-off marks on either of the screening instruments earlier used. Results : Most of the caregivers were offspring of the care-receivers (35.7%) and siblings (24.1%). Many of them (84%) did not know the care-receiver's diagnosis. More than half of the caregivers had lived and cared for their wards for more than two years. A lot of the caregivers (77.4%) had respite relief from care mostly given by the hospitals (43.7%) and other family members (35.8%) and about 72.2% of them also had other supportive measures from their relatives which included money (31.6%) and visits (25.4%). Despite this, most (64.2%) of the caregivers had difficulty with their care giving roles which was mainly financial in nature (42.4%) and sometimes antagonism from their care-recipients (15.1%). No social welfare or inter-agency assistance was available for 78.7% of caregivers. At least 90% of these caregivers reported self as being deeply religious individuals and 71.4% of them were appreciated for their care giving role by the care-recipients. A higher prevalence rate (16.5%) of depressive disorders was found in caregivers than in the noncaregivers (11.1%) but this was not statistically significant (X2=2.817, df=1, p=0.093). The prevalence of anxiety disorder was relatively similar for the two comparison groups being 11.3% in caregivers and 11.6% in the non-caregivers (X2=0.009, df=1, p=0.924). Noted however is that being single, elderly and formal-healthcareseeking was significantly associated with psychopathology in these caregivers. Conclusion : Overall, these Nigerian informal caregivers seemed not to be at a significantly higher risk for development of anxiety and depressive disorders in reaction to a stressful life situation like care giving to mentally-ill persons than their non-caregiving population. This is despite poor welfare support, major financial constraints and difficulty with their caregiving roles. Most of these caregivers however had good family support, appreciation from the care-receivers and deep religious affiliations and practices.