Identification of caregivers at greatest risk of major depression in two prevention studies

The high prevalence and negative consequences of depression in caregivers have led to the development of depression prevention programs for this population. Their efficacy might be influenced by depression risk factors, and different interventions might fit specific caregiver profiles. Study goals were to examine (1) which subgroups of female caregivers had the highest likelihood of major depression (MDD) onset by 12-month follow-up based on depression risk factors and participation in two depression prevention programs, and (2) specific MDD predictors for each prevention approach.

Data were analyzed from two randomized trials: (1) cognitive-behavioral group (CB) vs. usual care (UC); n = 165; (2) problem-solving group (PS) vs. UC; n =165 (mean age = 54.5).

Classification tree analysis showed that emotional distress (ED) was the strongest predictor in both trials. Additional MDD predictors were (i) lower age (for caregivers with low ED); (ii) working outside the home (for caregivers with intermediate ED); and (iii) higher autonomy in the care-recipient (for homemakers). The strongest predictors for each prevention intervention were lower age for CB, higher social class for PS, and ED and depressive symptoms for UC.

RESULTS implicate the utility of emotional distress for depression screening and the need to develop tailored interventions.