Poor mental health days and depressive disorders comparing non-caregivers, informal non-cancer caregivers, and informal caregivers of cancer patients: BRFSS 2022-23.
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PURPOSE: Informal caregivers are increasing in number, especially those caring for cancer patients, and caregiving can affect both patient outcomes and caregiver well-being. This study sought to elucidate whether the mental health outcomes differed among informal cancer caregivers, informal non-cancer caregivers, and non-caregivers. METHODS: Data from 2022 and 2023 Behavioral Risk Factor Surveillance Surveys (BRFSS) were analyzed for 24 states administering the caregiving module. The sample included non-caregivers(n = 157,539), informal non-cancer caregivers (n = 39,047), and informal cancer caregivers (n = 3,078). Logistic regressions identified factors associated with frequent mental distress days (FMD; ≥ 6 days of poor mental health in the last 30 days) and lifetime depression diagnosis. Models included caregiver status, reporting ≥ 14 poor physical health days monthly, exercise in the previous month, age, sex, marital status, education, employment, and rural/urban status, adjusted for U.S. region and year. RESULTS: In unadjusted comparisons, informal caregivers differed significantly from non-caregivers across several sociodemographic and health characteristics and were more likely to report FMD or a lifetime depression diagnosis. After adjusting for sociodemographics, year, U.S. region, physical health, and exercise, informal cancer caregivers had significantly higher odds of FMD than non-caregivers (aOR = 1.89, 95%CI = 1.58-2.26). Informal non-cancer caregivers had significantly higher odds of a lifetime depression diagnosis (aOR = 1.44, 95%CI = 1.36-1.52) than non-caregivers. CONCLUSION: Cancer caregiving was more strongly associated with frequent mental distress than with lifetime depression. Integrating clinical screening into patient visits and informal caregiver supports could help identify caregiving distress during periods of increased burden and facilitate timely supportive care.