October 19, 2005

Family caregivers lack mental health help

By Amy Norton

NEW YORK (Reuters Health) - Caring for a family member with
advanced cancer can take a heavy mental health toll, but many
caregivers may fail to get any psychiatric help, a new study

Researchers found that among 200 caregivers of patients
with advanced cancer, 13 percent met the criteria for a
significant psychiatric disorder --including panic disorder,
major depression, post-traumatic stress disorder and
generalized anxiety. But less than half of them had received
any professional help.

Past studies have found that caring for a seriously ill
family member exacts a significant toll, with caregivers often
having to quit their jobs and families losing their incomes and
savings. The emotional burden may be even greater; some
research has suggested that the strain of caring for a
seriously ill loved one can shorten the caregiver's life.

According to the authors of the new study, their findings
point to an unmet need in cancer care: the mental well-being of
patients' caregivers.

The doctors and nurses who care for cancer patients are in
an "ideal position" to help family caregivers get the
psychiatric care they need, said lead study author Dr. Lauren
C. Vanderwerker of the Dana-Farber Cancer Institute in Boston.

Through some screening questions, she told Reuters Health,
they could identify those family members who may need to be
referred for mental health care.

The study, published in the Journal of Clinical Oncology,
included 200 adults who were caring for a family member with
advanced cancer, usually their spouse or parent. Overall, one
quarter had sought help for emotional strain. But of those who
met formal criteria for a major psychiatric disorder, only 46
percent had received psychotherapy, medication or help from a
support group or clergy.

The findings indicate that many people neglect their own
mental health needs while caring for a seriously ill family
member, according to Vanderwerker. In this study, the most
common diagnosis was panic disorder, an anxiety disorder marked
by episodes of intense fear that arise out of nowhere. Overall,
8 percent of caregivers were diagnosed with panic disorder,
while 4.5 percent had major depression, the next most common

Caregivers' rate of panic disorder was more than twice that
seen in the general U.S. population, Vanderwerker noted. The
finding was somewhat surprising, she said, and it suggests that
any screening of caregivers should place particular attention
on this condition.

With cancer treatment now routinely given on an outpatient
basis, family caregivers have become responsible for such
things as giving medication, wound care and monitoring vital
signs, notes Dr. Ann O'Mara of the National Cancer Institute,
Bethesda, Maryland, in an editorial published with the study.

"Meeting the needs of our informal caregivers," she writes,
"is not just a medical problem, but a societal one requiring
the expertise, creativity, and energies of many disciplines."

SOURCE: Journal of Clinical Oncology, October 2005.