Prevalence of Major Depression and Assessment of Burden among Caregivers of Intellectually Differently Abled Persons: A Cross-sectional Study

Introduction: Intellectual Disability has major negative impact on the lives of the person and their families as they experience psychological distress and burden while providing care to them. Families while engaging in the caregiving process are said to experience psychiatric morbidities such as depression and anxiety more commonly. Identifying those helps in the holistic management of Intellectually differently abled persons together with caregivers. Aim: To assess major depression and caregiver's burden among caregivers of intellectually differently abled persons and their association with each other. Materials and Methods: This cross-sectional observational study among 220 caregivers was conducted at Psychiatry Department of Pandit Deendayal Upadhyay Government Medical Hospital in Rajkot district, Gujarat, India, from June 2018 to May 2019. Socio-demographic details of caregivers and intellectually differently abled persons were obtained after taking into consideration inclusion and exclusion criteria. Zarit scale of caregiver burden was used for burden assessment and its severity. Depression was screened by Patient Health Questionnaire. Those screened positive were evaluated in detail for major depression and diagnosed based on Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) criteria. Severity was assessed by Hamilton depression rating scale. Data were analysed to find out statistical significance with the help of t-test, Chi-square test, Fisher's-exact test and non parametric tests (Wilcoxon-Mann-Whitney U test and Kruskal-Wallis test). Probability value less than 0.05 was considered statistically significant. Results: Out of 220 caregivers, prevalence of major depressive disorder in caregivers as per DSM-5 was 25.45% (n=56). 23.18% (n=51) caregivers had severe burden, 45.45% (n=100) moderate to severe burden, 27.72% (n=61) mild to moderate burden, 3.63% (n=8) caregivers had little or no burden. Association between Intellectually differently abled persons with psychiatric and non-psychiatric co-morbidities and caregiver's depression were statistically significant (p-value=0.030). Association between intellectual disability severity (p-value=0.031), affected sibling of intellectually differently abled person (p-value<0.001) and caregivers' burden was statistically significant. Conclusion: The study emphasises that even though there's vast body of literature addressing psychological distress and suffering of caregivers of intellectually differently abled persons, it still remains a prominent challenge to manage it effectively. Thereby, treatment providers should shift their focus on the mental health of caregivers along with that of persons with intellectual disability as having healthy caregivers cannot only maximise the chances of intellectual disability persons' successful re-establishment in society but can themselves lead a psychologically healthy life.