Caregiving, alcohol use, and mental health symptoms among HMO members.

Using data from a survey of 5841 HMO members, we examined alcohol consumption, depression and anxiety symptoms, and health services use among 689 informal caregivers. Characteristics of caregivers included whom they cared for, types of care provided, number of people cared for, and whether care was provided in the caregiver's home. Outcome measures in hierarchical linear and logistic stepwise regression models included indicators of alcohol drinking pattern, symptoms of anxiety and depression, role limits due to emotional problems and self-reported doctor's visits. Adjusting for age and gender differences, caregivers reported more bodily pain, worse role functioning related to emotional problems, were more likely to screen as depressed, and were more likely to report symptoms of anxiety. Older caregivers, and those with greater vitality, had better mental health outcomes; caregivers with higher levels of education reported better psychological well-being and less interference with role functioning due to emotional problems. Caregivers did not make more doctor's visits than non-caregivers. No caregiving characteristics were consistently associated with both mental health and alcohol consumption outcomes. The relationship of the care recipient to the caregiver predicted mental health outcomes better than either the type of care, number cared for, or location of care. Both the type of care and relationship to the care provider were associated with alcohol consumption, and several gender interactions were identified. Our results confirm previous findings of greater mental health problems among caregivers, yet suggest that caregivers may not be seeking services commensurate to their needs.