Depression and Anxiety in family members of cancer patients: a cross-sectional study in Nepal

Family caregivers are described as co-sufferers in a battle against cancer. The prolonged and sustained nature of caregiving responsibilities, especially in a country like Nepal, where cultural and societal norms compromise familial responsibility, means that the burden of care is frequently shared among family members throughout diagnostic, treatment, and follow-up phases, which may lead to mental health issues in family caregivers. This study aims to find the prevalence of depression and anxiety among caregivers of cancer patients.

We conducted a descriptive cross-sectional study in a tertiary-level hospital in Nepal after approval from the Institutional Review Board. 101 participants were enrolled from August 2021 to August 2022 through non-probability convenience sampling. Participants were 18 years or older in age who gave informed consent, and had been caregivers for more than 1 month; while caregivers who had mental health issues before the diagnosis of cancer were excluded. Self-made questionnaires were used for demographical and socio-economic characteristics, while the Generalized Anxiety Disorder 7-item (GAD-7) anxiety scale and Patient Health Questionnaire-9 (PHQ-9) score were used to assess the prevalence of anxiety and depression, respectively. We used the Chi-square /Fisher's exact test to analyze the association between different variables.

The mean age of cancer patients was 58.1 years (±15.1). The mean age of caregivers of cancer patients was 40.1 years (±12.9). The majority of the participants were male (79.2%) and married (87.1%).Out of 101 caregivers, 80(79.2%) were males and 21(20.8%) were females. Overall, 59 participants (58.7%) had either mild, moderate, or severe anxiety, and 29 participants (28.7%) had either mild, moderate, or moderately severe depression. Male gender(p=0.023), higher education(p=0.072), relationship with the patient(p=0.002), and the patient's ECOG performance score(p=0.038) had a significant association with the severity of anxiety; and relationship with the patient (0.001) showed a significant association with the severity of depression.

The prevalence of depression and anxiety in family caregivers is considerably high. Interventions aimed at reducing mental health issues should also be focused on caregivers.