Skip to main content Accessibility help
×
Home

Prevalence and predictors of major depressive disorder in bereaved caregivers at 6 and 13 months

  • Seon-Young Kim (a1) (a2), Seung-Jeon Kim (a3), Jae-Min Kim (a1), Sung-Wan Kim (a1), Il-Seon Shin (a1), Hyun-Jeong Shim (a4), Sang-Hee Cho (a4), Ik-Joo Chung (a4) and Jin-Sang Yoon (a1)...

Abstract

Objective

Depressive symptoms are common in bereaved caregivers; however, there have been few prospective studies using a structured interview. This study investigated the prevalence and preloss predictors of major depressive disorder (MDD) in bereaved caregivers of patients in a palliative care unit.

Method

This prospective cohort study collected caregiver sociodemographic and psychological data before the death of a palliative care unit patient, including MDD, care-burden, coping style, and hopeful attitude. Postloss MDD was assessed 6 and 13 months after death, and a multivariate logistic regression analysis was conducted to identify its predictors.

Result

Of 305 caregivers contacted, 92 participated in this study. The prevalence of preloss MDD was 21.8%; the prevalences of postloss MDD were 34.8% and 24.7% at 6 and 13 months, respectively. Preloss MDD predicted postloss MDD at 6 months (odds ratio [OR] = 5.38, 95% confidence interval [CI95%] = 1.29, 22.43); preloss nonhopeful attitude and unemployment status of caregivers predicted postloss MDD at 13 months (OR = 8.77, CI95% = 1.87, 41.13 and OR = 7.10, CI95% = 1.28, 39.36, respectively).

Significance of results

Approximately 35% of caregivers suffered from MDD at 6 months postloss, but the prevalence of MDD decreased to about 25% at 13 months. Preloss MDD significantly predicted postloss MDD at 6 months, whereas hopeful attitude and unemployment at baseline were significantly associated with postloss MDD at 13 months.

Copyright

Corresponding author

Author for correspondence: Seon-Young Kim, Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-Ku, Gwangju 61469, Republic of Korea. E-mail: sykimpsy@chonnam.ac.kr

References

Hide All
Aber, CS (1992) Spousal death, a threat to women's health: paid work as a “resistance resource.” Image—The Journal of Nursing Scholarship 24(2), 9599.10.1111/j.1547-5069.1992.tb00231.x
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th ed, text revision. Washington, DC: American Psychiatric Press.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Press.
Allen, JY et al. (2013) Bereavement among hospice caregivers of cancer patients one year following loss: Predictors of grief, complicated grief, and symptoms of depression. Journal of Palliative Medicine 16(7), 745751.10.1089/jpm.2012.0450
Beck, AT et al. (1974) The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology 42(6), 861865.10.1037/h0037562
Breitbart, W et al. (2000) Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA 284(22), 29072911.10.1001/jama.284.22.2907
Cherlin, EJ et al. (2007) Bereavement services for family caregivers: How often used, why, and why not. Journal of Palliative Medicine 10(1), 148158.10.1089/jpm.2006.0108
Cho, MJ, Nam, JJ and Suh, GH (1998) Prevalence of symptoms of depression in a nationwide sample of Korean adults. Psychiatry Research 81(3), 341352.10.1016/S0165-1781(98)00122-X
Corden, A, Hirst, M and Nice, K (2008). Financial implications of death of a partner. Social Policy Research Unit: University of York, York, UK. Available from https://www.york.ac.uk/inst/spru/research/pdf/Bereavement.pdf
Fenix, JB et al. (2006) Religiousness and major depression among bereaved family caregivers: A 13-month follow-up study. Journal of Palliative Care 22(4), 286292.10.1177/082585970602200406
Garrido, MM and Prigerson, HG (2014) The end-of-life experience: Modifiable predictors of caregivers' bereavement adjustment. Cancer 120(6), 918925.10.1002/cncr.28495
Gort, AM et al. (2005) Short Zarit scale in palliative care. Medicina Clinica 124(17), 651653.10.1157/13074742
Große, J, Treml, J and Kersting, A (2018) Impact of caregiver burden on mental health in bereaved caregivers of cancer patients: A systematic review. Psychooncology 27(3), 757767.10.1002/pon.4529
Guldin, MB et al. (2012) Complicated grief and need for professional support in family caregivers of cancer patients in palliative care: a longitudinal cohort study. Supportive Care in Cancer 20(8), 16791685.
Jang, JE et al. (2013) Religiosity, depression, and quality of life in Korean patients with breast cancer: A 1-year prospective longitudinal study. Psychooncology 22(4), 922929.10.1002/pon.3083
Jho, HJ et al. (2016) Prevalence and associated factors of anxiety and depressive symptoms among bereaved family members of cancer patients in Korea: A nation-wide cross-sectional study. Medicine (Baltimore) 95(22), e3716.10.1097/MD.0000000000003716
Kim, SW et al. (2006) Correlates of caregiver burden for Korean elders according to cognitive and functional status. International Journal of Geriatric Psychiatry 21(9), 853861.10.1002/gps.1571
Kim, SY et al. (2014) Determinants of a hopeful attitude among family caregivers in a palliative care setting. General Hospital Psychiatry 36(2), 165171.10.1016/j.genhosppsych.2013.10.020
Kim, Y, Lucette, A and Loscalzo, M (2013). Bereavement needs of adults, children, and families after cancer. Cancer Journal 19(5), 444457.10.1097/PPO.0b013e3182a5babe
Kuo, SC et al. (2017). Longitudinal changes in and modifiable predictors of the prevalence of severe depressive symptoms for family caregivers of terminally ill cancer patients over the first two years of bereavement. Journal of Palliative Medicine 20(1), 1522.10.1089/jpm.2016.0116
Lin, N, Dean, A and Ensel, WM (1986) Social support, life events, and depression. New York: Academic Press.
Ling, SF et al. (2013) Trajectory and influencing factors of depressive symptoms in family caregivers before and after the death of terminally ill patients with cancer. Oncology Nursing Forum 40(1), E32E40.10.1188/13.ONF.E32-E40
Maciejewski, PK et al. (2007) An empirical examination of the stage theory of grief. JAMA 297(7), 716723.10.1001/jama.297.7.716
Nielsen, MK et al. (2017a) Predictors of Complicated Grief and Depression in Bereaved Caregivers: A Nationwide Prospective Cohort Study. Journal of Pain and Symptom Management 53(3), 540550.
Nielsen, MK et al. (2017b) Preloss grief in family caregivers during end-of-life cancer care: A nationwide population-based cohort study. Psychooncology 26(12), 20482056.10.1002/pon.4416
Park, JY (1995) A study on the relationship among character type A & B, ego-identity and stress coping (Dissertation: Graduate School of Sookmyung Women's University).
Pettersson, A et al. (2015) Which instruments to support diagnosis of depression have sufficient accuracy? A systematic review. Nordic Journal of Psychiatry 69(7), 497508.10.3109/08039488.2015.1008568
Roulston, A et al. (2017) Bereavement outcomes: A quantitative survey identifying risk factors in informal carers bereaved through cancer. Palliative Medicine 31(2), 162170.10.1177/0269216316649127
Rumpold, T et al. (2017) Hope as determinant for psychiatric morbidity in family caregivers of advanced cancer patients. Psychooncology 26(5), 672678.10.1002/pon.4205
Schrank, B, Stanghellini, G and Slade, M (2008) Hope in psychiatry: A review of the literature. Acta Psychiatrica Scandinavica 118(6), 421433.10.1111/j.1600-0447.2008.01271.x
Shear, MK et al. (2011) Complicated grief and related bereavement issues for DSM-5. Depression and Anxiety 28(2), 103117.10.1002/da.20780
Sheehan, DV et al. (1988) The mini-international neuropsychiatric interview (M.I.N.I): The development and validation of a structured diagnostic psychiatric interview for DSM-VI and ICD-10. Journal of Clinical Psychiatry 59(suppl. 20), 2233.
Shin, MS, Park, KW and Oh, KJ (1990) A study of suicidal ideation among high depression in CAPD patients 793 school students. Korean Journal of Clinical Psychology 9(1), 19.
Wakefield, JC, Schmitz, MF and Baer, JC (2011) Relation between duration and severity in bereavement-related depression. Acta Psychiatrica Scandinavica 124(6), 487494.10.1111/j.1600-0447.2011.01768.x
Williams, AL and McCorkle, R (2011) Cancer family caregivers during the palliative, hospice, and bereavement phases: a review of the descriptive psychosocial literature. Palliative and Supportive Care 9(3), 315325.
Zisook, S and Shuchter, SR (1991) Depression through the first year after the death of a spouse. American Journal of Psychiatry 148(10), 13461352.
Zisook, S et al. (2012) The bereavement exclusion and DSM-5. Depression and Anxiety 29(5), 425443.10.1002/da.21927

Keywords

Type Description Title
WORD
Supplementary materials

Kim et al. supplementary material
Table S1

 Word (17 KB)
17 KB

Metrics

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