Sylvie Lambert1,2, Lydia Ould Brahim3, Jane McCusker4,5, Chelsea Coumoundouros6, Li-Anne Audet3, Mark Yaffe4,7, John Kayser8, Mona Magalhaes4, Eric Belzile4, Nerida Turner4,9. 1. Ingram School of Nursing, McGill University, Montreal, QC, Canada. esylvie.lambert@mcgill.ca. 2. St. Mary's Research Centre, Montreal, Canada. esylvie.lambert@mcgill.ca. 3. Ingram School of Nursing, McGill University, Montreal, QC, Canada. 4. St. Mary's Research Centre, Montreal, Canada. 5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. 6. Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. 7. Department of Family Medicine, McGill University, Montreal, Canada. 8. Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada. 9. Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Canada.
Abstract
BACKGROUND: Caregivers experiencing depression or caring for people experiencing depression are at risk of high burden. This systematic review examined the effect of non-pharmacological interventions for caregivers that (a) target improving caregivers' depressive symptoms, (b) help caregivers manage the depressive symptoms of the person for whom they provide care, or (c) both (a) and (b). METHODS: Eligible trials published between January 1, 1985, and May 30, 2019 were retrieved from five electronic databases. The studies' methodological quality was assessed against 15 criteria. Pooled effect sizes (ESs) were calculated, and heterogeneity assessed using the Higgin's I2 statistic. Meta-regressions were also conducted to identify significant moderators (participant sub-group analyses) and mediators (identify how the interventions worked). RESULTS: Sixteen studies evaluating 18 interventions were included for review. These studies included a total of 2178 participants (mean = 94, SD = 129.18, range 25-518). The most common condition (n = 10/16) of the care recipient was dementia. The average methodological score was in the moderate range (8.76/15). Interventions had a moderate effect on caregivers' depression in the short term (ES = - 0.62, 95% CI - 0.81, - 0.44), but the effect dissipated over time (ES = - 0.19; 95% CI - 0.29, - 0.09). A similar pattern was noted for anxiety. The moderator analysis was not significant, and of the mediators examined, significant ones were self-management skills of taking action, problem solving, and decision-making. DISCUSSION: Non-pharmacological interventions are associated with improvement of depression and anxiety in caregivers, particularly in the short term. The main recommendation for future interventions is to include the self-management skills taking action, problem-solving, and decision-making. Enhancing the effect of these interventions will need to be the focus of future studies, particularly examining the impact of booster sessions. More research is needed on non-dementia caregiving and dyadic approaches.
BACKGROUND: Caregivers experiencing depression or caring for people experiencing depression are at risk of high burden. This systematic review examined the effect of non-pharmacological interventions for caregivers that (a) target improving caregivers' depressive symptoms, (b) help caregivers manage the depressive symptoms of the person for whom they provide care, or (c) both (a) and (b). METHODS: Eligible trials published between January 1, 1985, and May 30, 2019 were retrieved from five electronic databases. The studies' methodological quality was assessed against 15 criteria. Pooled effect sizes (ESs) were calculated, and heterogeneity assessed using the Higgin's I2 statistic. Meta-regressions were also conducted to identify significant moderators (participant sub-group analyses) and mediators (identify how the interventions worked). RESULTS: Sixteen studies evaluating 18 interventions were included for review. These studies included a total of 2178 participants (mean = 94, SD = 129.18, range 25-518). The most common condition (n = 10/16) of the care recipient was dementia. The average methodological score was in the moderate range (8.76/15). Interventions had a moderate effect on caregivers' depression in the short term (ES = - 0.62, 95% CI - 0.81, - 0.44), but the effect dissipated over time (ES = - 0.19; 95% CI - 0.29, - 0.09). A similar pattern was noted for anxiety. The moderator analysis was not significant, and of the mediators examined, significant ones were self-management skills of taking action, problem solving, and decision-making. DISCUSSION: Non-pharmacological interventions are associated with improvement of depression and anxiety in caregivers, particularly in the short term. The main recommendation for future interventions is to include the self-management skills taking action, problem-solving, and decision-making. Enhancing the effect of these interventions will need to be the focus of future studies, particularly examining the impact of booster sessions. More research is needed on non-dementia caregiving and dyadic approaches.
Authors: Steven H Belle; Louis Burgio; Robert Burns; David Coon; Sara J Czaja; Dolores Gallagher-Thompson; Laura N Gitlin; Julie Klinger; Kathy Mann Koepke; Chin Chin Lee; Jennifer Martindale-Adams; Linda Nichols; Richard Schulz; Sidney Stahl; Alan Stevens; Laraine Winter; Song Zhang Journal: Ann Intern Med Date: 2006-11-21 Impact factor: 25.391
Authors: Andrés Losada; María Márquez-González; Rosa Romero-Moreno; Brent T Mausbach; Javier López; Virginia Fernández-Fernández; Celia Nogales-González Journal: J Consult Clin Psychol Date: 2015-06-15
Authors: Lydia Ould Brahim; Sylvie D Lambert; Nancy Feeley; Chelsea Coumoundouros; Jamie Schaffler; Jane McCusker; Erica E M Moodie; John Kayser; Kendall Kolne; Eric Belzile; Christine Genest Journal: BMC Psychiatry Date: 2021-11-20 Impact factor: 3.630