title: Impact of Behavioral Symptoms in Dementia Patients on Depression in Daughter and Daughter-in-Law Caregivers.
abstract: One caregiver relationship that has been neglected in caregiver depression research is the daughter-in-law. Compared with Western countries, in which those who are closer in familial relationships such as the spouse or child usually take care of the patient, in many Asian countries, the daughter-in-law often assumes the caretaker role. However, not much research has been done on how this relationship may result in different caregiver outcomes. We sought to identify whether the association between patient characteristics and caregiver depressive symptoms differs according to the familial relationship between caregiver and patient.
  
  
  
  Ninety-five daughter (n = 47) and daughter-in-law (n = 48) caregivers of dementia patients were asked to report their own depressive symptoms and patient behavioral symptoms. Patients' cognitive abilities, daily activities, and global dementia ratings were obtained. Hierarchical linear regression was employed to determine predictors of depressive symptoms.
  
  
  
  Daughters-in-law had marginally higher depressive scores. After adjusting for caregiver and patient characteristics, in both groups, greater dependency in activities of daily living and more severe and frequent behavioral symptoms predicted higher caregiver depressive scores. However, greater severity and frequency of behavioral symptoms predicted depression to a greater degree in daughters compared with daughters-in-law.
  
  
  
  Although behavioral symptoms predicted depression in both caregiver groups, the association was much stronger for daughters. This suggests that the emotional relationship between the daughter and patient exacerbates the negative effect of behavioral symptoms on caregiver depression. The familial relationship between the caregiver and dementia patient should be considered in managing caregiver stress.
authors: 1 Department of Psychology, University of Kansas , Lawrence, Kansas.
authors: Juwon
authors: J
authors: Lee
authors: 2 Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine , Seoul, Republic of Korea.
authors: Bo Kyung
authors: BK
authors: Sohn
authors: 3 Department of Social Work, Daegu University , Gyeongsan, Republic of Korea.
authors: Hyunjoo
authors: H
authors: Lee
authors: 2 Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine , Seoul, Republic of Korea.
authors: Sujeong
authors: S
authors: Seong
authors: 4 Department of Education, Sejong University , Seoul, Republic of Korea.
authors: Soowon
authors: S
authors: Park
authors: 2 Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine , Seoul, Republic of Korea.
authors: Jun-Young
authors: JY
authors: Lee
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing*; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006701:Home Nursing / Q000523:psychology*; D006801:Humans; D007723:Korea; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family / Q000208:ethnology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D057566:Self Report
keywords: caregivers; daughters; daughters-in-law; dementia; depression