title: Stressors and common mental disorder in informal carers--an analysis of the English Adult Psychiatric Morbidity Survey 2007.
abstract: This study investigates potential explanations of the association between caring and common mental disorder, using the English Adult Psychiatric Morbidity Survey 2007. We examined whether carers are more exposed to other stressors additional to caring--such as domestic violence and debt--and if so whether this explains their elevated rates of mental disorder. We analysed differences between carers and non-carers in common mental disorders (CMD), suicidal thoughts, suicidal attempts, recent stressors, social support, and social participation. We used multivariate models to investigate whether differences between carers and non-carers in identifiable stressors and supports explained the association between caring and CMD, as measured by the revised Clinical Interview Schedule. The prevalence of CMD (OR=1.64 95% CI 1.37-1.97), suicidal thoughts in the last week (OR=2.71 95% CI 1.31-5.62) and fatigue (OR=1.33 95% CI 1.14-1.54) was increased in carers. However, caring remained independently associated with CMD (OR=1.58 1.30-1.91) after adjustment for other stressors and social support. Thus caring itself is associated with increased risk of CMD that is not explained by other identified social stressors. Carers should be recognized as being at increased risk of CMD independent of the other life stressors they have to deal with. Interventions aimed at a direct reduction of the stressfulness of caring are indicated. However, carers also reported higher rates of debt problems and domestic violence and perceived social support was slightly lower in carers than in non-carers. So carers are also more likely to experience stressors other than caring and it is likely that they will need support not only aimed at their caring role, but also at other aspects of their lives.
authors.affiliation: Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK. Electronic address: s.a.stansfeld@qmul.ac.uk.
authors.forename: Stephen
authors.initials: S
authors.lastname: Stansfeld
authors.affiliation: Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Smuk
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AZ UK.
authors.forename: Juliana
authors.initials: J
authors.lastname: Onwumere
authors.affiliation: Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Clark
authors.affiliation: Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: Cleo
authors.initials: C
authors.lastname: Pike
authors.affiliation: NatCen Social Research, 35 Northampton Square, London EC1V 0AX UK.
authors.forename: Sally
authors.initials: S
authors.lastname: McManus
authors.affiliation: Florence Nightingale School of Nursing and Midwifery, Kings College, London, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Harris
authors.affiliation: UCL Mental Health Sciences Unit, 2nd Floor, Charles Bell House 67-73, Riding House Street, London W1W 7EJ, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Bebbington
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D004739:England; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D016017:Odds Ratio; D012923:Social Class; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology
keywords: Carers; Common mental disorders; Mental health; Social support; Socioeconomic status; Stress; Suicide