晚发性抑郁症与阿尔茨海默病患者照料者负担的比较研究。
A comparative study of caregiver burden in late-onset depression and Alzheimer's disease.
作者信息
Kazhungil Firoz, Velayudhan Rajmohan, Kumar Manoj, Thazhe Mangool Raghuram
机构信息
Department of Psychiatry, Government Medical College, Manjeri, Kerala, India.
Department of Psychiatry, MES Medical College, Perinthalmanna, Kerala, India.
出版信息
Psychogeriatrics. 2016 May;16(3):209-15. doi: 10.1111/psyg.12141. Epub 2015 Jul 16.
BACKGROUND
Alzheimer's disease (AD) and major depressive disorder are the two most common psychogeriatric disorders. Late-onset depression (LOD) is the most common cause of emotional suffering in the elderly and is associated with a poor quality of life in caregivers. Although the burden on caregivers of individuals suffering from AD has been well studied, there is a paucity of comparative studies on caregiver burden between AD and LOD. The objectives of this study were to compare the caregiver burden in LOD and AD and to identify factors associated with caregiver burden in LOD.
METHODS
The study included two groups of 25 patients and their caregivers. Group 1 consisted of LOD patients diagnosed with major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision, with onset after age 60, and their caregivers. Group 2 consisted of AD patients and their caregivers. Caregiver burden was assessed by the Zarit Caregiver Burden Interview. Sociodemographic and clinical correlates of caregiver burden in LOD and AD were analyzed.
RESULTS
There was no significant difference in caregiver burden between LOD and AD (P = 0.27). In LOD, the factors positively associated with caregiver burden included the patient's education and the caregiver being a woman, married, unmarried, and a student. Factors negatively associated with caregiver burden included being the son of the patient and high income status. Multivariate stepwise regression analysis showed that caregiver burden in AD is predicted by the Behavioural Pathology in Alzheimer's Disease Scale score, income, presence of diabetes, and in-laws as caregivers (adjusted R(2) = 0.847, P < 0.001). In LOD, caregiver burden is predicted by income, the patient's education, and whether the caregiver is a student or spouse (adjusted R(2) = 0.388, P < 0.001).
CONCLUSION
This study highlights the finding that caregiver burden in LOD is comparable to that in AD and requires interventions to reduce the caregiver strain.
背景
阿尔茨海默病（AD）和重度抑郁症是两种最常见的老年精神障碍。晚发性抑郁症（LOD）是老年人情绪痛苦的最常见原因，并且与照料者的生活质量较差有关。尽管对AD患者照料者的负担已有充分研究，但关于AD和LOD照料者负担的比较研究却很少。本研究的目的是比较LOD和AD患者照料者的负担，并确定与LOD照料者负担相关的因素。
方法
本研究纳入两组，每组25名患者及其照料者。第1组由根据《精神障碍诊断与统计手册》第4版（修订版）诊断为重度抑郁症且发病年龄在60岁之后的LOD患者及其照料者组成。第2组由AD患者及其照料者组成。通过Zarit照料者负担访谈评估照料者负担。分析了LOD和AD照料者负担的社会人口学和临床相关因素。
结果
LOD和AD患者照料者的负担没有显著差异（P = 0.27）。在LOD中，与照料者负担呈正相关的因素包括患者的教育程度以及照料者为女性、已婚、未婚或学生。与照料者负担呈负相关的因素包括是患者的儿子以及高收入状态。多因素逐步回归分析显示，AD患者照料者负担由阿尔茨海默病行为病理量表评分、收入、糖尿病的存在以及照料者为姻亲所预测（调整R(2)=0.847，P < 0.001）。在LOD中，照料者负担由收入、患者的教育程度以及照料者是学生还是配偶所预测（调整R(2)=0.388，P < 0.001）。
结论
本研究突出了这一发现，即LOD患者照料者的负担与AD患者照料者的负担相当，需要采取干预措施以减轻照料者的压力。
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