Skip to main content Accessibility help
×
Home

Mental and physical illness in caregivers: results from an English national survey sample

  • Lindsay Smith (a1), Juliana Onwumere (a1), Tom Craig (a2), Sally McManus (a3), Paul Bebbington (a4) and Elizabeth Kuipers (a5)...

Abstract

Background

Caregivers make a significant and growing contribution to the social and medical care of people with long-standing disorders. The effective provision of this care is dependent on their own continuing health.

Aims

To investigate the relationship between weekly time spent caregiving and psychiatric and physical morbidity in a representative sample of the population of England.

Method

Primary outcome measures were obtained from the Adult Psychiatric Morbidity Survey 2007. Self-report measures of mental and physical health were used, along with total symptom scores for common mental disorder derived from the Clinical Interview Schedule – Revised.

Results

In total, 25% (n = 1883) of the sample identified themselves as caregivers. They had poorer mental health and higher psychiatric symptom scores than non-caregivers. There was an observable decline in mental health above 10 h per week. A twofold increase in psychiatric symptom scores in the clinical range was recorded in those providing care for more than 20 h per week. In adjusted analyses, there was no excess of physical disorders in caregivers.

Conclusions

We found strong evidence that caregiving affects the mental health of caregivers. Distress frequently reaches clinical thresholds, particularly in those providing most care. Strategies for maintaining the mental health of caregivers are needed, particularly as demographic changes are set to increase involvement in caregiving roles.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Mental and physical illness in caregivers: results from an English national survey sample
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Mental and physical illness in caregivers: results from an English national survey sample
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Mental and physical illness in caregivers: results from an English national survey sample
      Available formats
      ×

Copyright

Corresponding author

Lindsay Smith, Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. Email: lindsay.smith@kcl.ac.uk

Footnotes

Hide All

Declaration of interest

None.

Footnotes

References

Hide All
1 Shahly, V, Chatterji, S, Gruber, MJ, Al-Hamzawi, A, Alonso, J, Andrade, LH, et al. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys. In Psychol Med 2013, 43: 115.
2 White, C. 2011 Census Analysis: Unpaid Care in England and Wales, 2011 and Comparison with 2001. Office for National Statistics, 2013 (http://www.ons.gov.uk/ons/dcp171766_300039.pdf).
3 Colombo, F, Llena-Nozal, A, Mercier, J, Tjadens, F. Help Wanted? Providing and Paying for Long-Term Care: Providing and Paying for Long-Term Care. OECD Publishing, 2011 (http://dx.doi.org/10.1787/9789264097759-en).
4 Christensen, K, Doblhammer, G, Rau, R, Vaupel, JW. Ageing populations: the challenges ahead. Lancet 2009; 374: 1196–208.
5 Department of Health. Recognised, Valued and Supported: Next Steps for the Carers Strategy. Department of Health, 2010 (https://www.gov.uk/government/publications/recognised-valued-and-supported-next-steps-for-the-carers-strategy).
6 Cameron, ID, Aggar, C, Robinson, AL, Kurrle, SE. Assessing and helping carers of older people. BMJ 2011; 343: 1756–833.
7 Cormac, I, Tihanyi, P. Meeting the mental and physical healthcare needs of carers. Adv Psychiatr Treat 2006; 12: 162–72.
8 Schulz, R, Sherwood, PR. Physical and mental health effects of family caregiving. Am J Nurs 2008; 108: 23–7.
9 Pinquart, M, Sörensen, S, Stress, P. Differences between caregivers and non-caregivers in psychological health and physical health: a meta-analysis. Psychol Aging 2003; 18: 250–67.
10 Vitaliano, PP, Zhang, J, Scanlan, JM. Is caregiving hazardous to one's physical health? A meta-analysis. Psychol Bull 2003; 129: 946–72.
11 Pinquart, M, Sörensen, S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci 2007; 62: 126–37.
12 Buyck, J-F, Bonnaud, S, Boumendil, A, Andrieu, S, Bonenfant, S, Goldberg, M, et al. Informal caregiving and self-reported mental and physical health: results from the Gazel Cohort Study. Am J Public Health 2011; 101: 1971–9.
13 Phillips, AC, Gallagher, S, Hunt, K, Der, G, Carroll, D. Symptoms of depression in non-routine caregivers: the role of caregiver strain and burden. Br J Clin Psychol 2009; 48: 335–46.
14 Schulz, R, Visintainer, P, Williamson, GM. Psychiatric and physical morbidity effects of caregiving. J Gerontology 1990; 45: 181–91.
15 Cooper, C, Balamurali, TBS, Livingston, G. A systematic review of the prevalence and covariates of anxiety in caregivers of people with dementia. Int Psychogeriatr 2007; 19: 175–95.
16 Cuijpers, P. Depressive disorders in caregivers of dementia patients: a systematic review. Aging Ment Health 2005; 9: 325–30.
17 National Centre for Social Research and University of Leicester. Adult Psychiatric Morbidity Survey, 2007 (3rd edn). UK Data Archive, 2011 (http://discover.ukdataservice.ac.uk/catalogue/?sn=6379&type=Data%20catalogue).
18 Kish, L. A procedure for objective respondent selection within the household. In J Am Statist 1949, 44: 380–7.
19 Department for Health. Survey of Carers in Households. NHS Information Centre for Health and Social Care, 2010 (http://www.hscic.gov.uk/PUB02200/surv-care-hous-eng-2009-2010-rep1.pdf).
20 Office for National Statistics. 2011 Census in England and Wales: Glossary. UK Data Service Census Support (http://www.ons.gov.uk/ons/guide-method/census/2011/census-data/2011-census-user-guide/glossary/index.html).
21 Maher, J, Green, H. Carers 2000: results from the carers module of the General Household Survey 2000. TSO, 2002.
22 Lewis, G, Pelosi, AJ, Araya, RC, Dunn, G. Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychol Med 1992; 27: 765–74.
23 Bebbington, P, Brughra, T, Meltzer, H, Farrell, M, Ceresa, C, Jenkins, R, Lewis, G. Psychiatric disorder and dysfunction in the UK National Survey of Psychiatric Morbidity. Soc Psychiatry and Psychiatr Epidemiol 2000; 35: 191–7.
24 McHorney, CA, Ware, JE, Lu, JF, Sherbourne, CD. The MOS 36-item Short Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions and reliability across diverse patient groups. Med Care 1994; 32: 4066.
25 Hays, RD, Sherbourne, CD, Mazel, RM. The rand 36-item health survey 1.0. Health Econ 1993; 2: 217–27.
26 Gandek, B, Ware, JE, Aaronson, NK, Apolone, G, Bjorner, JB, Brazier, JE, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 1998; 51: 1171–8.
27 Ware, JE, Gandek, B, Kosinski, M, Aaronson, NK, Apolone, G, Brazier, J, et al. The equivalence of SF-36 summary health scores estimated using standard and country specific algorithms in 10 countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 1998; 51: 1167–70.
28 McHorney, CA, Ware, JE, Raczek, AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247–63.
29 Wilson, D, Parsons, J, Tucker, G. The SF-36 summary scales: problems and solutions. Soz Präventivmed 2000; 45: 239–46.
30 Burholt, V, Nash, P. Short Form 36 (SF-36) Health Survey Questionnaire: normative data for Wales. J Public Health (Oxf) 2011; 33: 587603.
31 Jenkinson, C. Comparison of UK and US methods for weighting and scoring the SF-36 summary measures. J Public Health Med 1999; 21: 372–6.
32 McManus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R. Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. NHS Information Centre for Health and Social Care, 2009 (http://www.ic.nhs.uk/pubs/psychiatricmorbidity07).
33 Young, H, Grundy, E, Kalogirou, S. Who cares? Geographic variation in unpaid caregiving in England and Wales: evidence from the 2001 Census. Popul Trends 2005; 120: 2334.
34 King, D, Balarajan, M, Blake, M, Cheshire, H, Darton, R, Gray, M, et al. Developing Improved Survey Questions on Older People's Receipt of, and Payment for, Formal and Informal Care. Personal Social Services Research Unit Discussion Paper (2764). London School of Economics and Political Science, 2010.
35 Lynn, P. Quality Profile: British Household Panel Survey, Version 2.0: Waves 1–13, 1991–2003. University of Essex, 2006 (http://www.iser.essex.ac.uk/bhps/quality-profile).
36 Legg, L, Weir, C, Langhorne, P, Smith, L, Stott, D. Is informal caregiving independently associated with poor health? A population-based study. J Epidemiol Community Health 2013; 67: 95–7.
37 Hirst, M. Carer distress: a prospective, population-based study. Soc Sci Med 2005; 61: 697708.
38 Spiers, N, Bebbington, PE, McManus, S, Brugha, T, Jenkins, R, Meltzer, H. Age and birth cohort differences in the prevalence of common mental disorder in England: the National Psychiatric Morbidity Surveys, 1993 to 2007. Br J Psychiatry 2011; 198: 479–84.
39 Jorm, AF. Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psych Med 2000; 30: 1122.
40 Singleton, N, Maung, N, Cowie, A, Sparks, J, Bumpstead, R, Meltzer, H. Mental Health of Carers. TSO, 2002 (http://collection.europarchive.org/tna/20090106142604/http://statistics.gov.uk/downloads/theme_health/Mental_Health_of_Carers_June02.pdf).
41 Lazarus, RS, Folkman, S. Stress, Appraisal, and Coping. Springer Publishing Company, 1984.
42 Szmukler, GI, Burgess, P, Herrman, H, Bloch, S, Benson, A, Colusa, S. Caring for relatives with serious mental illness: the development of the Experience of Caregiving Inventory. Soc Psychiatry and Psychiatr Epidemiol 1996; 31: 137–48.
43 Van den Berg, B, Spauwen, P. Measurement of informal care: an empirical study into the valid measurement of time spent on informal caregiving. Health Econ 2006; 15: 447–60.
44 McManus, S, Mowlam, A, Dorsett, R, Stansfeld, S, Clark, C, Brown, V, et al. Mental Health in Context: The National Study of Work-Search and Wellbeing. Department of Work and Pensions, Research Report 810, 2012 (http://statistics.dwp.gov.uk/asd/asd5/rports2011-2012/rrep810.pdf).
45 Department of Health. No Health without Mental Health. A Cross Government Mental Health Outcomes Strategy for People of all Ages. Department of Health, 2011 (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/135457/dh_124058.pdf.pdf)
46 Department of Health. Carers at the Heart of 21st-Century Families and Communities. A Caring System on your Side. A Life of your Own. Department of Health, 2008 (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/136492/carers_at_the_heart_of_21_century_families.pdf).
47 Jones, R, Mackenzie, A, Greenwood, N, Atkins, C, Habbibi, R. Evaluation of the Pilot GP Training Programme on Carers. Kingston University & St George's, University of London, 2010 (http://eprints.kingston.ac.uk/16429/).
48 Princess Royal Trust for Carers, Royal College of General Practioners. Supporting Carers: An Action Guide for General Practioners and their Teams. PRTC and RCGP, 2011. (http://static.carers.org/files/prtc-final-3640.pdf).
49 Carers, UK. Improving GP Support for Carers. Carers UK, no date (http://www.carersuk.org/get-involved/carer-ambassadors).
50 Arksey, H, Hirst, M. Unpaid carers' access to and use of primary care services. Prim Health Care Res Dev 2005; 6: 101–16.

Mental and physical illness in caregivers: results from an English national survey sample

  • Lindsay Smith (a1), Juliana Onwumere (a1), Tom Craig (a2), Sally McManus (a3), Paul Bebbington (a4) and Elizabeth Kuipers (a5)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Mental and physical illness in caregivers: results from an English national survey sample

  • Lindsay Smith (a1), Juliana Onwumere (a1), Tom Craig (a2), Sally McManus (a3), Paul Bebbington (a4) and Elizabeth Kuipers (a5)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *