Caregiver Burden and Depression Among Informal Caregivers of HIV-infected Individuals

Authors

  • Paul A. Pirraglia MD, MPH,

    1. Research Unit, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI, USA
    2. Department of Medicine, Brown University, Providence, RI, USA
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  • Duane Bishop MD,

    1. Department of Medicine, Brown University, Providence, RI, USA
    2. Department of Psychiatry and Human Behavior, Brown University and Rhode Island Hospital, Providence, RI, USA
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  • Debra S. Herman PhD,

    1. Research Unit, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI, USA
    2. Department of Medicine, Brown University, Providence, RI, USA
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  • Elizabeth Trisvan BSW,

    1. Research Unit, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI, USA
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  • Rosalie A. Lopez,

    1. Research Unit, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI, USA
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  • Christopher S. Torgersen BA,

    1. Research Unit, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI, USA
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  • Ann Marie Van Hof BS,

    1. Research Unit, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI, USA
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  • Bradley J. Anderson PhD,

    1. Research Unit, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI, USA
    2. Department of Medicine, Brown University, Providence, RI, USA
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  • Ivan Miller PhD,

    1. Department of Medicine, Brown University, Providence, RI, USA
    2. Department of Psychiatry and Human Behavior, Brown University and Butler Hospital, Providence, RI, USA
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  • Michael D. Stein MD

    1. Research Unit, Division of General Internal Medicine, Rhode Island Hospital, Providence, RI, USA
    2. Department of Medicine, Brown University, Providence, RI, USA
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  • There are no conflicts of interest to report on the part of any author of this manuscript.

  • Earlier findings of this work were presented at the NIMH International Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS, Atlanta, GA, July 22, 2004.

Address correspondence and requests for reprints to Dr. Pirraglia: Rhode Island Hospital, 593 Eddy Street, MPB-1, Providence, RI 02903 (e-mail: ppirraglia@lifespan.org).

Abstract

Background: Few studies have examined the factors associated with depression in informal caregivers of HIV-infected persons.

Objective: To investigate the relationship between depression and caregiver burden among informal caregivers of HIV-infected individuals.

Design: Cross-sectional study using baseline data from an ongoing randomized trial of a supportive telephone intervention.

Participants: One hundred seventy-six dyads of HIV patients and their informal caregiver.

Measurements: Depression was defined as a Beck Depression Inventory >10. A Caregiver Strain Index >6 identified informal caregivers with a high caregiver burden. We used logistic regression to identify characteristics that were associated with depression in the informal caregiver.

Results: Informal caregivers were 42 years old (SD, 13), 53% female, 59% nonwhite, and 30% had education beyond high school. Forty-seven percent of informal caregivers were the patient's partner, 18% a friend, and 35% a family member. Twenty-seven percent of informal caregivers had a high caregiver burden, and 50% were depressed. We found significantly greater odds of informal caregiver depression with high caregiver burden (OR, 6.08; 95% CI, 2.40 to 15.4), informal caregiver medical comorbidity besides HIV (OR, 2.32; 95% CI, 1.09 to 4.92), spending all day together (OR, 3.92; 95% CI, 1.59 to 9.69), having to help others besides the HIV patient (OR, 2.55; 95% CI, 1.14 to 5.74), and duration of the HIV patient's diagnosis (OR, 1.01 per month; 95% CI, 1.00 to 1.01).

Conclusions: High caregiver burden was strongly associated with depression among HIV-infected individuals' informal caregivers, who themselves had difficult life circumstances. Informal caregivers of HIV patients may be in need of both mental health services and assistance in caregiving.

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