Screening Cancer Caregivers for Depression

In a recent study, researchers found a link between symptoms of depression and worsening long-term physical health for caregivers of patients with cancer. The study’s conclusions suggest that screening caregivers for symptoms of depression could alert them to steps to offset the worsening physical health which caregivers often experience.

Writing in Cancer, clinical psychologist Kelly Schaffer, Ph.D., and the other researchers commented on the results of their work: “Findings highlight the unique contribution of caregivers' depressive symptoms to their physical health decline.”

Researchers looked at caregivers’ health two years, five years and eight years after the diagnosis of their loved one. Data was provided by the American Cancer Society’s National Quality of Life Survey for Caregivers. Self-reported responses from 664 cancer caregivers were reviewed.

Two years after diagnosis of a loved one, caregivers’ symptoms of depression were not found to be linked at all to their overall physical health. Instead, several other factors were associated with health at this benchmark: demographic factors like age, income and ethnicity, severity of the patient’s cancer, and reported stress. In fact, at this early stage, caregivers reported slightly better health on average than members of the general US population.

As the researchers expected, caregiver physical health was worse than the general US population at both the five year and eight year benchmarks. Researchers found that reporting symptoms of depression at year two was the only factor surveyed that was associated with decline in physical health at these later benchmarks. The caregivers who reported symptoms of depression at the two-year benchmark did not report poorer health than those who did not report such symptoms at this benchmark.

This means that regarding their physical health, caregivers with symptoms of depression are indistinguishable from those without these symptoms at first. Yet, three years later, they show a measurable decline in physical health, declining at twice the rate of caregivers with an average level of depressive symptoms. The significance of symptoms of depression as a predictor for worsening health was found uniform among the demographics surveyed.

“Assessing and addressing symptoms of depression among caregivers early in the cancer survivorship trajectory may help to prevent premature health decline among this important yet vulnerable population,” the researchers wrote. They hope that these findings will be useful in preventing those physical health declines often reported by caregivers.

Likely, researchers believe, caregivers with depression experience the same difficulties with exercise, sleep, and nutrition faced by other people with depression. Presumably, caregivers’ depression can be addressed in the same way that depression is addressed in the general population. In addition, caregiver support groups and caregiver-specific reading materials, both of which address caregiver-specific needs, promise to improve caregivers’ mental health.

Schaffer, lead researcher on this study, expects that targeting caregivers’ depression soon after the diagnosis of a loved one with cancer may prevent their physical health decline later. "Identifying caregivers in need, and connecting these caregivers to effective and accessible psychosocial services, are imperative next steps to improve comprehensive care for families facing cancer,” said Dr. Shaffer in a press release.

Worsening caregiver health has a negative effect both on caregivers’ quality of life and on their ability to care for loved ones with cancer. There is now evidence that, unique among the factors analyzed in this study, experiencing symptoms of depression contributes to this widespread problem.