Anxiety and depression associated with caregiver burden in caregivers of stroke survivors with spasticity

Arch Phys Med Rehabil. 2013 Sep;94(9):1731-6. doi: 10.1016/j.apmr.2013.03.014. Epub 2013 Mar 30.


Objective: To investigate the relationship between anxiety/depression and caregiver burden in informal caregivers of stroke survivors with spasticity.

Design: Data were collected via online surveys from informal caregivers 18 years or older who cared for stroke survivors.

Setting: Internet-based survey.

Participants: 2007 through 2009 U.S. National Health and Wellness Survey database or Lightspeed Research general panel respondents (N=153).

Interventions: Not applicable.

Main outcome measures: Anxiety and depression were self-reported by the caregiver as a physician diagnosis. Depression severity was measured by the Patient Health Questionnaire-9 (PHQ-9). Caregiver burden was measured by the Oberst Caregiving Burden Scale (OCBS) and the Bakas Caregiving Outcomes Scale (BCOS). Logistic regression analyses were conducted with anxiety, depression, and the PHQ-9 depression severity categories as a result of each caregiver burden scale.

Results: Data were analyzed for 153 informal caregivers; they were mostly women (70.6%) and white (78.4%), with a mean age of 51.6 years. For every 1-point increase in the OCBS Difficulty Scale, the odds of anxiety or depression were 2.57 times as great (P<.001) and 1.88 times as great (P=.007), respectively. The odds of PHQ-9 severe depression versus all other categories combined were 2.48 times as great (P<.001). For every 1-point decrease in the BCOS, the odds of anxiety or depression were 2.43 times as great (P<.001) and 2.27 times as great (P=.002), respectively. The odds of PHQ-9 severe depression versus all other categories combined were 4.55 times as great (P<.001).

Conclusions: As caregiver burden increases, caregivers are more likely to have anxiety and depression. Depression severity also increases. Providing treatment to stroke survivors with spasticity that lessens the time and more importantly, the difficulty of caregiving may lead to a reduction in caregiver anxiety and depression.

Keywords: Anxiety; BCOS; Bakas Caregiving Outcomes Scale; CI; Caregivers; Depression; LSR; Lightspeed Research; MS; Muscle spasticity; NHWS; National Health and Wellness Survey; OCBS; Oberst Caregiving Burden Scale; PHQ-9; Patient Health Questionnaire-9; Rehabilitation; Stroke; confidence interval; multiple sclerosis.

MeSH terms

  • Adaptation, Psychological
  • Anxiety / epidemiology*
  • Caregivers / psychology*
  • Depression / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / etiology*
  • Patient Acuity
  • Quality of Life
  • Self Report
  • Stroke / complications*