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转诊至老年精神科服务的患者照料者的照料负担及抑郁的患病率和预测因素

Prevalence and predictors of carer burden and depression in carers of patients referred to an old age psychiatric service.

作者信息

Molyneux G J, McCarthy G M, McEniff S, Cryan M, Conroy R M

机构信息

Department of Psychiatry, Tallaght Hospital, Dublin, Ireland.

出版信息

Int Psychogeriatr. 2008 Dec;20(6):1193-202. doi: 10.1017/S1041610208007515. Epub 2008 Jun 30.

Abstract

BACKGROUND

Too little is currently known about the prevalence of and risk factors for depression and carer strain among informal carers of community-dwelling elderly mentally ill. This study seeks to assess the prevalence of depression, using the Geriatric Depression Scale-15 (GDS-15), the degree of carer burden/strain, and their risk factors among the primary informal carers of patients referred to our community-based old age psychiatry service.

METHODS

A cross-sectional study design was used, with the subjects comprising 100 primary informal carers of patients who live at home and were referred to our service. The main carer measures were the GDS-15 and an adapted version of Gilleard's Strain Scale. Patients were assessed the Clifton Assessment Procedure for the Elderly-Survey version, the GDS-15 and the Mini-mental State Examination.

RESULTS

Depression was found in 21% of the carers (a score of 5 or more on the GDS-15). The more problem behaviors identified and the greater the functional impairment of the patient, the higher the strain score deciles and the more likely the carer was to be depressed. Spouses were associated with lower carer strain scores. Patient diagnoses did not affect carer depression or carer strain.

CONCLUSION

We found high levels of depression in the primary carers of community-dwelling patients attending an old age psychiatric service. The patients' behavior and their cognitive and functional ability conferred greater risk of carer depression or strain than their diagnosis. These risk factors may help identify carers at risk of strain and depression.

摘要

背景

目前对于社区居住的老年精神病患者的非正式照料者中抑郁症的患病率及其危险因素了解甚少。本研究旨在使用老年抑郁量表15项版(GDS - 15)评估抑郁症的患病率、照料者负担/压力程度及其在转介至我们社区老年精神病服务机构的患者的主要非正式照料者中的危险因素。

方法

采用横断面研究设计,研究对象包括100名在家居住并转介至我们服务机构的患者的主要非正式照料者。主要的照料者测量工具为GDS - 15和吉利亚德压力量表的改编版。对患者进行了老年人克利夫顿评估程序调查版、GDS - 15和简易精神状态检查表评估。

结果

在21%的照料者中发现有抑郁症(GDS - 15得分5分及以上)。识别出的问题行为越多且患者的功能损害越大,压力得分十分位数越高,照料者患抑郁症的可能性就越大。配偶的照料者压力得分较低。患者的诊断并未影响照料者的抑郁情况或照料者压力。

结论

我们发现在接受老年精神病服务的社区居住患者的主要照料者中抑郁症发病率很高。患者的行为及其认知和功能能力比其诊断结果导致照料者患抑郁症或承受压力的风险更大。这些危险因素可能有助于识别有压力和抑郁风险的照料者。

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