Coping Among Those Who Care for Seriously Ill Anorexia Nervosa Patients

In a study of 252 caregivers involved with 178 patients, caregivers reported that helping them cope with their responsibilities was more helpful than emotional support.

Professional and social support can alleviate caregivers’ distress and may be particularly valuable for partners, who are more isolated than are parents of patients with anorexia nervosa hospitalized for intensive care, according to the results of a recent study.

Researchers at King’s College, London, explored objective burden time (time spent caregiving and the number of tasks), subjective burden (psychological distress), and social support in 224 parents and 28 partners from a consecutive series of 178 patients admitted to inpatient units within the United Kingdom (Int J Eat Disord 2012;Oct 26 [Epub ahead of print]).

The research team, led by Dr. Simone Raenker, found that most of the caregivers’ time was spent providing emotional support, and less was spent performing practical tasks. Time spent with caregiving was associated with carer distress and was fully mediated by carer burden. This in turn was mediated by social support. Partners received only minimal support from others, and there were similar levels of burden and distress for mothers as well. According to the authors, their study results also suggest practical support for caregivers was more helpful than was emotional support.

Factors that may help predict the degree of distress

An earlier study at King’s College examined factors that could be helpful for predicting the degree of distress among those caring for persons with eating disorders (Br J Clin Psychology 2007; 46:413). The researchers evaluated 155 persons currently caring for someone with an eating disorder; the participants completed self-report assessments of psychological disorders (General Health Questionnaire-12; GHQ-12), experience of caregiving, illness representations and caregiving needs.

About 36% of caregivers had scores on the GHQ that indicated they themselves had mental health difficulties, and 17% of these experienced high psychological distress. A negative experience of caregiving was associated with the carer’s distress. Two factors that most highly predicted the caregivers’ distress were the degree of dependency of the patient and the stigma associated with the illness. Other factors that increased carer distress were shorter duration of illness, higher levels of needs (lower levels of support) and perceptions of greater consequences from the illness.