OBJECTIVES: This study describes the mental health status, disability, physical health, and mental health service utilization of informal care-givers under the age of 65 in the province of Ontario. METHODS: The study analyzed data collected in the 1991 province-wide, population-based mental health supplement to the Ontario Health Survey. Diagnoses from the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised, were generated on the basis of a structured diagnostic interview. Caregivers and noncaregivers are compared here on past-year prevalence of psychiatric disorder, physical illness, disability, and utilization of mental health services. The possible confounding effects of age, sex, employment status, and economic disadvantage are explored. RESULTS: Informal caregivers (n = 1219) constituted 15.0% of the sample. Caregivers had higher rates of affective (6.3% vs 4.2%) and anxiety (17.5% vs 10.9%) disorders than noncaregivers and used health services for mental health problems at nearly twice the rate. CONCLUSIONS: Documentation of the prevalence of caregiving and the increased prevalence of psychiatric disorders, disability, and service utilization among caregivers is of critical importance as governments continue to move toward community-based care. To accomplish this goal, the needs of caregivers must be acknowledged and met by the establishment of appropriate and readily accessible support services.

SynopsisIn a 2-year study of conjugal bereavement, 26 of 99 women remained highly distressed throughout the course of the study. Of the remaining 73 women, 30 never gave evidence of ‘high distress’. Deficits in social support, health and financial problems correlate with enduring ‘high distress’. Personality traits consonant with a socially acceptable and expected ‘widow role’ were found to differentiate the women with enduring ‘low distress’.

Sixty-four women undergoing radiotherapy for breast cancer in a residential setting which offered structured cognitive and emotional support, are compared for level of psychological distress and satisfaction with staff support with 104 women living at home during treatment. The outcome measures were the 30-item Goldberg General Health Questionnaire (GHQ) and a 5-item author-constructed Treatment Support Index. A surprisingly large percentage of the sample did not, at any time, manifest appreciable psychological distress. For those women whose level of distress changed by a GHQ score of 3 or more over the three week course of treatment, residence in the Lodge was associated with decreased risk of change for the worse, and increased probability of change for the better. Results from the Treatment Support Index indicate that a significantly greater percentage of Lodge residents than non-residents were satisfied with the quantity, quality, and/or diversity of support available to them.

Remarriage is a growing phenomenon for which its members are likely to be poorly prepared, due to inadequate institutionalization of this form of the nuclear family

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