Psychosomatic Symptoms, Depression, and Anxiety among Parents and Caregivers of People With Disability
Background: Caring for people with disabilities creates stressful conditions and may lead to mental health problems in parents and caregivers. The aim of this study was to investigate somatic symptoms, depression, and anxiety in parents and caregivers of individuals with disability in Isfahan, Iran. This study was conducted as a joint study by Isfahan University of Medical Sciences and the University of Hamburg with financial support from DAAD.
Methods: This cross-sectional study was performed on 454 parents/caregivers of people with disabilities in Isfahan in 2019. Randomized sampling was performed and participants were selected according to the inclusion criteria. The Patient Health Questionnaire-9 (PHQ-9) (Depression), PHQ-7 (Anxiety), and PHQ-15 (Somatic) were used for data collection. Questionnaires were distributed among the participants and completed with the coordination and cooperation of the government and NGOs related to people with disability. Data were analyzed using descriptive statistics (mean and standard deviation) and analysis of variance (ANOVA) in SPSS software.
Results: The results showed that 28.4% of parents/caregivers of people with disabilities did not have any depressive symptoms and the remaining 70% experienced mild to severe levels of depressive symptoms. Regarding the level of anxiety, 30.2% showed no symptoms of anxiety and 69.8% showed mild to severe levels of anxiety symptoms. In terms of somatic symptoms, 17.8% reported no somatic symptoms and 82.2% reported mild to severe levels of somatic symptoms. Parents/caregivers differed significantly in terms of depression, anxiety, and somatic symptoms according to the type of disability.
Conclusion: The findings of the present study show that the rate of symptoms of depression, anxiety, and somatic symptoms in parents/caregivers of people with disabilities is higher than that in the general population. In addition, different types of disability can have different effects on the mental health of parents/caregivers.
Al-Kuwari, M. G. (2007). Psychological health of mothers caring for mentally disabled children in Qatar. Neurosciences.(Riyadh.), 12(4), 312-317. doi:20070417 [pii]. Retrieved from PM:21857552
Chadda, R. K. (2014). Caring for the family caregivers of persons with mental illness. Indian J Psychiatry, 56(3), 221-227. doi:10.4103/0019-5545.140616 [doi];IJPsy-56-221 [pii]. Retrieved from PM:25316932
Chi, T. C., & Hinshaw, S. P. (2002). Mother-child relationships of children with ADHD: the role of maternal depressive symptoms and depression-related distortions. J Abnorm.Child.Psychol, 30(4), 387-400. doi:10.1023/a:1015770025043 [doi]. Retrieved from PM:12109489
Cooper, S. A., Smiley, E., Morrison, J., Williamson, A., & Allan, L. (2007). Mental ill-health in adults with intellectual disabilities: prevalence and associated factors. Br J Psychiatry, 190, 27-35. doi:S0007125000233242 [pii];10.1192/bjp.bp.106.022483 [doi]. Retrieved from PM:17197653
Cuskelly, M., Pulman, L., & Hayes, A. (1998). Parenting and employment decisions of parents with a preschool child with a disability. Journal of Intellectual & Developmental Disability, 23(4), 319-332.
Ebrahimi, A., Seyed Mirramazani, M., Hosseini, S, M. (2020). Comparison of depression, anxiety and somatic symptom disorders between Isfahan and Marburg participants [Thesis for Completion Psychiatry Assistant].
Emerson, E. (2003). Mothers of children and adolescents with intellectual disability: social and economic situation, mental health status, and the self-assessed social and psychological impact of the child's difficulties. J Intellect.Disabil Res, 47(Pt 4-5), 385-399. doi:498 [pii];10.1046/j.1365-2788.2003.00498.x [doi]. Retrieved from PM:12787168
Feldman, M., McDonald, L., Serbin, L., Stack, D., Secco, M. L., & Yu, C. T. (2007). Predictors of depressive symptoms in primary caregivers of young children with or at risk for developmental delay. J Intellect.Disabil Res, 51(Pt 8), 606-619. doi:JIR941 [pii];10.1111/j.1365-2788.2006.00941.x [doi]. Retrieved from PM:17598874
Fritz, H. L. (2020). Coping with caregiving: Humor styles and health outcomes among parents of children with disabilities. Res Dev.Disabil, 104, 103700. doi:S0891-4222(20)30130-X [pii];10.1016/j.ridd.2020.103700 [doi]. Retrieved from PM:32497974
Hastings, R. P. (2003). Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. J Intellect.Disabil Res, 47(Pt 4-5), 231-237. doi:485 [pii];10.1046/j.1365-2788.2003.00485.x [doi]. Retrieved from PM:12787155
Kayili, G. (2018). Depression, anxiety and stress among parents of disabled children. In Sosyal ve Beseri Bilimler Arastirmalari (pp. 355-364). Konya, Turkey: Çizgi Kitabevi.
Kobayashi, T., Inagaki, M., & Kaga, M. (2012). Professional Caregiver's View on Mental Health in Parents of Children with Developmental Disabilities: A Nationwide Study of Institutions and Consultation Centers in Japan. ISRN.Pediatr., 2012, 121898. doi:10.5402/2012/121898 [doi]. Retrieved from PM:22389791
Krishnan, V., Sood, M., & Chadda, R. K. (2013). Caregiver burden and disability in somatization disorder. J Psychosom.Res, 75(4), 376-380. doi:S0022-3999(13)00337-1 [pii];10.1016/j.jpsychores.2013.08.020 [doi]. Retrieved from PM:24119946
Kroenke K., & Spitzer R.L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 509-515.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2002). The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom.Med, 64(2), 258-266. doi:10.1097/00006842-200203000-00008 [doi]. Retrieved from PM:11914441
Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B., Berry, J. T., & Mokdad, A. H. (2009). The PHQ-8 as a measure of current depression in the general population. J Affect.Disord, 114(1-3), 163-173. doi:S0165-0327(08)00282-6 [pii];10.1016/j.jad.2008.06.026 [doi]. Retrieved from PM:18752852
Kroenke, K., Spitzer, R. L., Williams, J. B., & Lowe, B. (2010). The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen.Hosp Psychiatry, 32(4), 345-359. doi:S0163-8343(10)00056-3 [pii];10.1016/j.genhosppsych.2010.03.006 [doi]. Retrieved from PM:20633738
Lynch, J., & Cahalan, R. (2017). The impact of spinal cord injury on the quality of life of primary family caregivers: a literature review. Spinal.Cord., 55(11), 964-978. doi:sc201756 [pii];10.1038/sc.2017.56 [doi]. Retrieved from PM:28653672
Manea, L., Gilbody, S., & McMillan, D. (2012). Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis. CMAJ., 184(3), E191-E196. doi:cmaj.110829 [pii];10.1503/cmaj.110829 [doi]. Retrieved from PM:22184363
Moes, D., Koegel, R. L., Schreibman, L., & Loos, L. M. (1992). Stress profiles for mothers and fathers of children with autism. Psychol Rep., 71(3 Pt 2), 1272-1274. doi:10.2466/pr0.1992.71.3f.1272 [doi]. Retrieved from PM:1480714
Olsson, M. B., & Hwang, C. P. (2001). Depression in mothers and fathers of children with intellectual disability. J Intellect.Disabil Res, 45(Pt 6), 535-543. doi:372 [pii];10.1046/j.1365-2788.2001.00372.x [doi]. Retrieved from PM:11737541
Olsson, M. B., & Hwang, C. P. (2008). Socioeconomic and psychological variables as risk and protective factors for parental well-being in families of children with intellectual disabilities. J Intellect.Disabil Res, 52(12), 1102-1113. doi:JIR1081 [pii];10.1111/j.1365-2788.2008.01081.x [doi]. Retrieved from PM:18507702
Pelchat, D., Lefebvre, H., & Perreault, M. (2003). Differences and similarities between mothers' and fathers' experiences of parenting a child with a disability. J Child.Health Care, 7(4), 231-247. doi:10.1177/13674935030074001 [doi]. Retrieved from PM:14636429
Plummer, F., Manea, L., Trepel, D., & McMillan, D. (2016). Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen.Hosp Psychiatry, 39, 24-31. doi:S0163-8343(15)00240-6 [pii];10.1016/j.genhosppsych.2015.11.005 [doi]. Retrieved from PM:26719105
Resch, J. A., Elliott, T. R., & Benz, M. R. (2012). Depression among parents of children with disabilities. Fam Syst Health, 30(4), 291-301. doi:2012-30285-001 [pii];10.1037/a0030366 [doi]. Retrieved from PM:23148978
Romans-Clarkson, S. E., Clarkson, J. E., Dittmer, I. D., Flett, R., Linsell, C., Mullen, P. E. et al. (1986). Impact of a handicapped child on mental health of parents. Br Med J (Clin Res Ed.), 293(6559), 1395-1397. doi:10.1136/bmj.293.6559.1395 [doi]. Retrieved from PM:2948606
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Kaplan & Sadock's Comprehensive Textbook of Psychiatry. Kaplan and Sadocks Comprehensive Textbook of Psychiatry (10th ed.). Philadelphia, PA: Wolters Kluwer.
Schwartz, C., & Tsumi, A. (2003). Parental Involvement in the Residential Care of Persons with Intellectual Disability: The Impact of Parents' and Residents' Characteristics and the Process of Relocation. Journal of Applied Research in Intellectual Disabilities, 16(4), 285-293.
Simpson, G. K., Anderson, M. I., Jones, K. F., Genders, M., & Gopinath, B. (2020). Do spirituality, resilience and hope mediate outcomes among family caregivers after traumatic brain injury or spinal cord injury? A structural equation modelling approach. NeuroRehabilitation., 46(1), 3-15. doi:NRE192945 [pii];10.3233/NRE-192945 [doi]. Retrieved from PM:32039872
Spitzer, R. L., Kroenke, K., Williams, J. B., & Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern.Med, 166(10), 1092-1097. doi:166/10/1092 [pii];10.1001/archinte.166.10.1092 [doi]. Retrieved from PM:16717171
Teymoori, A., Gorbunova, A., Haghish, F. E., Real, R., Zeldovich, M., Wu, Y. J. et al. (2020). Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury. J Clin Med, 9(3). doi:jcm9030873 [pii];10.3390/jcm9030873 [doi]. Retrieved from PM:32210017
Weiss, J. A., Sullivan, A., & Diamond, T. (2003). Parent stress and adaptive functioning of individuals with developmental disabilities. Journal on Developmental Disabilities, 10(1), 129-135.
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