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ANXIETY, DEPRESSION AND BURDEN OF CARE AMONG CARERS OF CHILDREN WITH SEIZURE DISORDERS

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Supervisor: Dr. T . O Adebowale Dr. P. O Onifade
Faculty: PSYCHIATRY
Month: 05
Year: 2013

Abstract

Background: Several studies in Nigeria have examined the burden of care and psychiatric morbidity among caregivers of patients with dementia, schizophrenia and epilepsy. However, few studies have specifically assessed the burden of care and psychiatric morbidity among carers of children with seizure disorders. Yet evidence worldwide suggests that these carers go through immense burden and prevalence of psychological distress is very high among them. Aim: The aim of this study was to assess the prevalence and correlates of psychiatric morbidity and burden of care among carers of children with seizure disorders attending the Child and Adolescent Clinic of the Neuropsychiatric Hospital Aro, Abeokuta. The objectives included determining the relationship between carers sociodemographic characteristics and psychiatric morbidity. Method: A sociodemographic questionnaire was administered to 202 caregivers attending the clinic between November 2011 and February 2012. The Zarit Burden Interview was used to assess burden of care among them, while Structured Clinical Interview for DSM – IV axis 1 Diagnosis (SCID) was used for diagnosis of Generalized Anxiety Disorder and Major Depression. Results: One hundred and forty six (72%) of the carers were females, with mothers of patients accounting for 66%. The prevalence of psychiatric morbidity was 51.0%. Among the caregivers, 39.5% reported little or no burden, 20% reported mild to moderate burden, while 40.5% reported severe burden. There was a significant relationship between burden of care and psychiatric morbidity (2 = 1.40, df= 2, p= 0.001). The sociodemographic characteristics of carers associated with psychiatric morbidity included older age range (2 =18.67, df=2, p=0.001), being employed (2 =10.41, df= 3, p=0.015), longer duration of care (2 =18.07, df=2, p=0.001) and being patients’ mother (2 =10.17, df= 2, p=0.032). Patients’ clinical variable associated with psychiatric morbidity included: longer duration of illness (2 =16.97, df=2, p<0.0001), frequency of seizures in 4 weeks prior to interview (2 =6.80, df=1, p=0.009), duration of last seizure episode prior to interview (2 =30.79, df=2, p<0.0001) and last seizure episode prior to the interview (2 =70.77, df=2, p<0.0001)., Conclusion: Carers of children with seizure disorders experienced immense burden, in this study over 40% of the carers reported severe burden. Prevalence of psychiatric morbidity is high among these carers (over 50%) and is related to their sociodemographic characteristics and patients sociodemographic and clinical variables. These findings suggest the need to adopt a wholistic approach to the detection of these disorders and developing adequate intervention. Formation of support groups among these carers and provision of psychological intervention by health care team can go a long way in ameliorating these problems.

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