The mental health of women in middle life, and the effect of the burden of care-giving

Summary

To assess the impact of care-giving on mental health of women between 50 and 65, we interviewed a random selection of 229 women obtained from general practice lists. We assessed psychiatric state by the short form of the Present State Examination and the General Health Questionnaire (GHQ) and made a clinical diagnosis in terms of Research Diagnostic Criteria. We assessed social circumstances by a modified form of the Life Events and Difficulties Schedule, noting involvement in major, moderate and minor support to various dependants, as well as to events, difficulties and social support. We found that 45 women (20%) had a raised GHQ score, and 51 (23%) an RDC diagnosis, including 32 (14%) with major or minor depression. 136 (60%) were involved in support of some kind, including 91 (40%) in major support. The main associations of poor mental health were life events and difficulties, and lack of social contact. On the whole, supporters, including those supporting elderly relatives, were a healthy group. Certain subgroups appeared more at risk, including those supporting children with brain damage, and those with a resident elderly relative. In a small minority – 9/136 supporters, i.e. 7% of supporters and 4% of the sample, support became a "difficulty", in the sense used by Brown and Harris (1978), and was a risk factor for depression. Some of the results suggest that the caretaker role has a beneficial effect, or is associated with robust mental health.