Investigation of Anxiety, Depression, Sleep, and Family Function in Caregivers of Children With Epilepsy

Abstract

Objective: Epilepsy is a chronic disease that places a heavy burden on caregivers. Previous studies have shown that caregivers of epilepsy patients often experience anxiety and depression; however, few comprehensive studies have assessed their sleep quality and family function. Based on the current understanding of the anxiety and depression state of caregivers in children with epilepsy, we further explored the caregivers' sleep and family function and evaluated the predictors of the depression state of caregivers.Methods: In this cross-sectional online anonymous survey, we sent an online questionnaire to the caregivers of children with epilepsy who visited our hospital. The QR code of the questionnaire was scanned at the follow-up course to conduct an online survey. The questionnaire contained questions about sociodemographic and clinical information, the Self-rating Anxiety Scale, Self-rating Depression Scale, Pittsburgh Sleep Quality Index, and the Family Assessment Device.Results: A total of 308 caregivers of children with epilepsy aged 0–12 years were included in this study. The mean age of children with epilepsy was 4.8 ± 3.18 years, and the average illness duration was 34.2 ± 29.18 months. Further, 47.1% of the children took three or more anti-seizure medications, and 43.2% were on ketogenic diet therapy. We found that in 77.9% of the cases, the subjects were the mothers, in 89% there was more than one co-caregiver, and in 51.9%, financial help was required. Further, 63.6% of the caregivers thought they could not get enough access to disease knowledge education, and 83.7% perceived epilepsy was a terrible disease. Our results also showed that 65.6% of the caregivers were in depression status, 41.9% were in anxiety status, and 49.0% had poor sleep quality. The proportion of unhealthy family functioning in each subscale was 45.1–96.1%, and the unhealthy behavior control function accounted for 96.1%. Binary logistic regression analysis of the data showed that without co-caregivers [odds ratio (OR), 5.193], free of anxiety status (OR, 0.063), good sleep quality (OR, 0.446), healthy family role dimension (OR, 0.344), and healthy family general functional dimension (OR, 0.259) were predictors of depression status in caregivers of children with epilepsy.Conclusion: Anxiety and depression status are common in caregivers of children with epilepsy, with depression status being more prominent. Moreover, a considerable proportion of caregivers had poor sleep quality and unhealthy family function. The caregivers' anxiety status, sleep quality, family role dimension, family general function dimension, and the number of co-caregivers were predictors of depression status in caregivers. In clinical practice, caregivers' anxiety and depression status, poor sleep quality, and unhealthy family functioning should be addressed along with the treatment of children with epilepsy.

The Mediating Roles of Family Resilience and Social Support in the Relationship Between Illness Severity and Depressive Symptoms Among Primary Caregivers of Children With Epilepsy in China

“…In the present study, the prevalence of depressive symptoms was 69.84%. A recent cross-sectional research conducted among 308 caregivers of children with epilepsy found that the proportion of depression accounts for 65.60% (18), which was consistent with our reported incidence of depression. In other studies, the prevalence of depressive symptoms ranged from 23.5 to 55% (8,9).…”

“…Furthermore, raising a child with severe epilepsy was highly related to caregivers' distress and depressive symptoms ( 17 ). But the latest study showed that the disease severity of CWE cannot predict parental depression in China ( 18 ). The relationship between epilepsy severity and depression is contradictory.…”

Examination of Care Burden and Hopelessness Levels of Parents with Children with Epilepsy

“…Caregivers' perceptions and attitudes towards epilepsy can also affect them psychologically, as caregivers often experience negative emotions (Murugupillai et al, 2016). Studies have shown that depression and anxiety are experienced by almost half of all caregivers (Zhang et al, 2021). Carers may experience anxiety over various aspects of the condition, including physical, behavioural and cognitive function, psychological and social function, educational performance, and the future with regard to epilepsy and its management (Murugupillai et al, 2016).…”

The role of clinical and psychological research in epilepsy

“…An increased level of self-stigmatization is associated with low socioeconomic status [7], difficulties with employment, low level of medical literacy, failure to follow the prescribed treatment, concealment of the diagnosis, number of seizures [8]. The existence of intrapersonal conflicts, aggression, dysphoric disorder, depressive disorder in patients with epilepsy [9,10,11], causes the occurrence of frequent and regular conflict situations in the family and in the professional sphere of these patients, which naturally worsens their social adaptation in modern society, and requires professional intervention in the form of rehabilitation and psychocorrectional measures [12,13,14].…”