A pilot study for a smartphone app for the prevention of depression in non-professional caregivers.

OBJECTIVES: The main objective of the current study was to evaluate the feasibility and acceptability of a cognitive-behavioral prevention intervention administered through a smartphone app in non-professional caregivers with symptoms of depression. The secondary objective was to make a preliminary evaluation of its effectiveness either alone or supplemented with telephone conference calls. METHODS: Eighty-seven participants (Mage = 51.8 years) were randomly assigned to an app-based cognitive-behavioral intervention (CBIA; n = 29), CBIA supplemented with telephone conference calls (CBIA + CC; n = 28), or an attention control group (ACG; n = 30). The participants for both interventions received five cognitive-behavioral modules through the app, and those in CBIA + CC an additional 30-minute phone call in each module. RESULTS: 3.4% of caregivers dropped out. In all groups, the number of modules completed was high. Participants completed a high percentage of the homework and were highly satisfied with both CBIA and CBIA + CC. At post-intervention, there was a lower incidence of depression and depressive symptoms for CBIA + CC compared with CBIA, and for CBIA and CBIA + CC compared with ACG. CONCLUSION: The results supported the feasibility and acceptability of the cognitive-behavioral intervention, and demonstrated that telephone contact improves its effectiveness.

Problem-solving intervention to prevent depression in non-professional caregivers: a randomized controlled trial with 8 years of follow-up.

BACKGROUND: Studies of psychological interventions for the prevention of depression have found significant effects in the short-term, but the long-term efficacy has yet to be determined. This study evaluated the 8-year effect of a randomized controlled trial for indicated prevention of depression in female caregivers. METHODS: A total of 173 non-professional female caregivers with subclinical depressive symptoms not meeting criteria for a major depressive episode (MDE) were randomized to either a brief problem-solving intervention (n = 89) or usual-care control group (n = 84). Blinded evaluators conducted an assessment at the 8-year follow-up. The primary outcome was Depression Status, defined by diagnoses of MDE since the 1-year follow-up using the Structured Clinical Interview for the Disorders of the DSM-5. The secondary outcome was current Depressive Symptom Severity. Regression analyses were conducted to evaluate the effect of the intervention on the outcomes. RESULTS: There were no significant differences in the Depression Status between the problem-solving (30.3%) and control groups (26.2%) (adjusted OR 1.25, 95% CI -0.58 to 2.69). Depressive Symptom Severity, however, was significantly lower in the problem-solving group compared to the control group at this follow-up, amounting to a small effect size of Cohen's d = 0.39 (adjusted B = -3.32, p = 0.018). CONCLUSIONS: This is the first study to assess such a long-term follow-up of intervention of indicated prevention of depression. Results seem to indicate that the protective effect of the intervention became smaller over time during follow-up. Future research should replicate these results.

Identification of non-professional caregivers with high resilience using sociodemographic, care, and personal and social development variables.

Objectives: Despite the importance of resilience in well-being and adaptation to the role of caregiver in non-professional caregivers, research on resilience in this population has been scarce and contradictory, and has methodological limitations. The objective of this study was to identify subgroups of caregivers with high levels of resilience based on a series of predictors including sociodemographic variables and variables related to care and personal and social development.Method: 294 non-professional caregivers (89.8% women) with a mean age of 55.3 years (SD = 10.9) were randomly selected. Trained evaluators collected the sociodemographic variables of the person in care and the caregiver and on the care situation, self-esteem, social support, emotional distress and resilience.Results: The Classification Tree Analysis (CTA) showed that self-esteem was the main predictor of high resilience. Additional predictors were: (1) for those with high self-esteem, longer duration of care; (2) for those with low self-esteem, less emotional distress; (3) for those with less emotional distress, shorter duration of care.Conclusion: The results offer guidelines for developing programs to promote high resilience.

Spanish validation of the 10-item Connor-Davidson Resilience Scale (CD-RISC 10) with non-professional caregivers.

OBJECTIVES: Despite the importance of resilience in populations under stress, and the fact that the 10-item version Connor-Davidson Resilience Scale (CD-RISC 10) is the shortest instrument for reliable and valid evaluation of resilience, there are no data on their psychometric properties in non-professional caregivers. The aim of this study was to analyze the psychometric properties and factorial structure of the spanish version of the CD-RISC 10 in non-professional caregivers. METHOD: Independently trained assessors evaluated resilience, self-esteem, social support, emotional distress and depression in a sample of 294 caregivers (89.8% women, mean age 55.3 years). RESULTS: The internal consistency of CD-RISC 10 was α = .86. A single factor was found that accounted for 44.7% of the total variance. Confirmatory factor analysis corroborated this unifactorial model. The CD-RISC 10 was significantly correlated with the self-esteem (r = .416, p < .001) and social support (r = .228, p < .001) scales, and the emotional distress scale (r = -.311, p < .001), though this was an inverse relationship. A score ≤ 23 was a suitable cut-off point for discriminating caregivers with depression (sensitivity = 70.0%, specificity = 68.2%). CONCLUSION: The CD-RISC 10 is a reliable and valid instrument to evaluate resilience in the caregiver population.

Prevalence and correlates of burnout in health professionals in Ecuador.

BACKGROUND: Although burnout is a widespread phenomenon among healthcare professionals, there are no studies about its prevalence in Ecuador. This study assesses the prevalence of burnout syndrome among Ecuadorian healthcare professionals and examine the relationship with their personal and organizational characteristics. METHODS: A total of 2404 healthcare professionals (average age 40.0years; 68.4% women) from the capitals of all 24 provinces in Ecuador participated in this study. Trained psychologists assessed the presence of burnout by applying the Maslach Burnout Inventory. Sociodemographic variables, emotional distress, social support and coping styles as well as organizational variables were also collected. RESULTS: Of all healthcare professionals surveyed, 2.6% presented burnout syndrome. By dimensions, 17.2% of the participants presented a high level of emotional exhaustion, 13.5% of depersonalization, and 18.2% had reduced personal accomplishment. Being non-mestizo, being classified as a probable case of mental disorder and using more passive coping were associated with a greater probability of presenting burnout; having >10years of experience was associated with a lower probability of burnout. CONCLUSIONS: A significant number of active health professionals suffer from burnout. It is necessary to develop effective psychotherapeutic interventions for those who have the syndrome and to evaluate potential prevention strategies in those who have not yet developed it.

Analysis of the components of a cognitive-behavioral intervention administered via conference call for preventing depression among non-professional caregivers: a pilot study.

OBJECTIVES: The primary aim was to assess the feasibility/acceptability of a preventive cognitive-behavioral intervention implemented via conference call for caregivers. The secondary aim was to conduct a preliminary assessment of the efficacy of the behavioral activation component alone compared to the complete cognitive-behavioral intervention. METHOD: Sixty-one caregivers (mean age 58.4 years) were randomly assigned to a cognitive-behavioral intervention via conference call (CBC, n = 20), a behavioral activation intervention via conference call (BAC, n = 22) or a control group receiving usual care (CG, n = 19). Both interventions consisted of five 90-minute group sessions implemented weekly. RESULTS: Only 6.6% of caregivers discontinued the study. In the CBC and BAC groups, attendance and satisfaction with the intervention were similarly high among both groups. Homework adherence was also high in both groups. At post-treatment, there was a lower incidence of depression in the CBC and BAC groups compared to the CG (0.0% for BAC and CBC vs. 10.5% for CG). The relative risk was 0.0, and number needed to treat was 10 in both groups. Depressive symptoms were significantly reduced in the CBC and BAC groups compared to the CG (d = 2.18 and d = 2.06). CONCLUSION: The results support the feasibility of the intervention. Moreover, the BAC intervention was non-inferior to the CBC intervention for reducing depressive symptoms.

Long-term Follow-up of a Randomized Clinical Trial Assessing the Efficacy of a Brief Cognitive-Behavioral Depression Prevention Intervention for Caregivers with Elevated Depressive Symptoms.

OBJECTIVES: To evaluate the efficacy of a cognitive-behavioral intervention for the prevention of depression in caregivers with elevated depressive symptoms through 12 months of follow-up. DESIGN: Randomized controlled trial. SETTING: Community in Galicia (Spain). PARTICIPANTS: 170 caregivers with elevated depressive symptoms. INTERVENTIONS: Caregivers were randomized to a cognitive-behavioral intervention (N = 88), administered to groups of five participants in five weekly 90-min sessions, or to a usual care control group (N = 82). MEASUREMENTS: Major depressive episodes (according to the Structured Clinical Interview for Axis I Disorders of the DSM-IV), depressive symptoms, emotional distress, caregiver burden, pleasant activities, depressive thoughts, social contacts. Trained blinded interviewers conducted assessments at 1, 3, 6, and 12 months of follow-up. RESULTS: At the 12-month follow-up, there was a lower incidence of major depressive episodes in the intervention group compared with the control group (3.4% versus 22.0%). The relative risk was 0.15 (95% CI: 0.05-0.51) and the number needed to treat was 5 (95% CI: 3-11). The time of delay of the depressive episode onset in the intervention group was significant. Caregivers with good compliance to the intervention had a lower incidence of depression. The effects of the intervention on depressive symptoms, emotional distress, and caregiver burden were maintained for 12 months. Younger caregivers were more likely to benefit from the intervention. The change in depressive thoughts mediated the reduction in depressive symptoms. CONCLUSIONS: Depressive episodes can be successfully prevented in caregivers, with long-term effects.

Protocol for a randomized controlled dismantling study of a brief telephonic psychological intervention applied to non-professional caregivers with symptoms of depression.

BACKGROUND: Although depression is a common problem in caregivers and there are effective cognitive-behavioral interventions for its prevention, the ability of caregivers to attend these treatments is often limited by logistics. Furthermore, the efficacy of the components of these interventions is unknown. The objectives of this study are to (a) evaluate the efficacy of a telephone-administered cognitive-behavioral intervention to prevent depression with all its components (cognitive and behavioral) and only with behavioral activation, and to (b) analyze the mediators of the change in depressive symptoms. METHODS/DESIGN: A randomized controlled clinical trial was designed to dismantle the components of a cognitive-behavioral intervention. Caregivers with elevated depressive symptoms will be randomly assigned to a cognitive-behavioral intervention, an intervention with only the behavioral activation component, or a usual care control group. Each condition will consist of approximately 60 participants. The two interventions will consist of five sessions lasting 90 min each, applied to groups of about 5 participants at a time via conference call. Trained interviewers, blind to the experimental conditions, will conduct the assessments at the pre-treatment, post-treatment and 1-, 3-, 6- and 12-month follow-ups. DISCUSSION: This study will provide evidence of the efficacy of a cognitive-behavioral intervention to prevent depression in caregivers with elevated depressive symptoms administered via conference call, and on the impact of the behavioral activation component on the overall efficacy of the program. If we find favorable results, it would mean that we have developed a program of prevention of depression of higher clinical utility and efficacy than those currently available, which would make it possible for a large number of caregivers to have access to such resources. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02292394. Registered 6 November 2014.

RELATIONSHIP OF COGNITIVE BEHAVIORAL THERAPY EFFECTS AND HOMEWORK IN AN INDICATED PREVENTION OF DEPRESSION INTERVENTION FOR NON-PROFESSIONAL CAREGIVERS (.).

Activities designed to be performed outside of the intervention are considered an essential aspect of the effectiveness of cognitive-behavioral therapy. However, these have received little attention in interventions aimed at individuals with subclinical depressive symptoms who do not yet meet diagnostic criteria for depression (indicated prevention). In this study, the completion of tasks given as homework and their relationship with post-treatment depressive symptoms was with relation to an indicated prevention of depression intervention. Eighty-nine female non-professional caregivers recruited from an official registry completed an intervention involving 11 homework tasks. Tasks performed were recorded and depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Among caregivers, 80.9% completed 9-11 tasks. The number of tasks performed was associated with post-treatment depressive symptoms, with 9 being optimal for clinically significant improvement. These findings highlight the relationship between homework and post-treatment depressive symptoms.

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

OBJECT: 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. METHOD: 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). RESULTS: 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. CONCLUSIONS: RESULTS implicate the utility of emotional distress for depression screening and the need to develop tailored interventions.

A randomized controlled pilot study of a cognitive-behavioral video game intervention for the promotion of active aging.

Background: Due to the accessibility barriers of in-person programs for active aging, the development of programs that use innovative technologies is needed. Video games can be an engaging tool for disseminating active aging interventions. Objective: The objective of this pilot study was to analyze the feasibility of a cognitive-behavioral intervention to promote active aging administered through a video game. Methods: Fifty-five participants (63.6% women, mean age = 53.0 years) were randomly assigned to a cognitive-behavioral intervention to promote active aging administered through an interactive multimedia online video game with a complementary app (CBI-V; n = 29) or to a control group that received nonspecific online information (CG; n = 26). Results: Only 3.6% of the participants dropped out of the study (6.9% in CBI-V and 0.0% in CG; without significant differences between groups). The mean number of modules completed was 7.6 (SD = 0.9) out of 8 in the CBI-V and 7.9 (SD = 0.5) in the control group (CG), without significant between-group differences. In the CBI-V, the mean total time dedicated to the game was 516.8 min (SD = 94.3), including 143.2 min (SD = 31.6) of cognitive training tasks, and the mean of completed tasks was 206.2 (SD = 33.7) out of 259. Participants were highly engaged (M = 39.9, SD = 8.6) and satisfied (M = 25.8, SD = 4.5) with the intervention. After the intervention, the CBI-V group significantly improved on SF-36 dimensions of General Health (p = .0386), Vitality (p = .0283), Social Functioning (p = .0130), and Physical Summary Index (p = .0370) compared to the CG, with medium effect sizes (d = 0.56-0.75). Conclusions: The results demonstrate the feasibility of the video game intervention to promote active aging and encourage conducting a large-scale randomized controlled trial.

Efficacy of a Cognitive Behavioral Intervention for the Prevention of Depression in Nonprofessional Caregivers Administered through a Smartphone App: A Randomized Controlled Trial.

Due to the limited availability of in-person interventions for caregivers, the development of effective programs that use new technologies to prevent depression is needed. The goal of this research was to assess the efficacy of a cognitive behavioral intervention for the prevention of depression, administered to nonprofessional caregivers through a smartphone application (app). One hundred and seventy-five caregivers were randomly assigned to either an app-based cognitive behavioral intervention (CBIA), the CBIA intervention plus a telephone conference call (CBIA + CC), or an attention control group (ACG). At post-intervention, the incidence of depression was lower in the CBIA and CBIA + CC compared to the ACG (1.7% and 0.0% vs. 7.9%, respectively). The absolute risk, relative risk, and number needed to treat compared to the ACG were 6.2%, 21.6%, and 16 for the CBIA, whilst they were 8%, 0.0%, and 13 for the CBIA + CC. Depressive symptomatology was significantly lower in the CBIA and CBIA + CC compared to the ACG (d = 0.84, Cliff's δ = 0.49; d = 1.56, Cliff's δ = 0.72), as well as in the CBIA + CC compared to the CBIA (d = 0.72, Cliff's δ = 0.44). The prevention of depression was more likely in participants who received the CBIA, and adding the conference call in the CBIA + CC group improved the likelihood of this.

Reliability and Validity of the Geriatric Depression Scale in a Sample of Portuguese Older Adults with Mild-to-Moderate Cognitive Impairment.

Although the Geriatric Depression Scale (GDS) is a well-established instrument for the assessment of depressive symptoms in older adults, this has not been validated specifically for Portuguese older adults with cognitive impairment. The objective of this study was to analyze the psychometric properties of two Portuguese versions of the GDS (GDS-27 and GDS-15) in a sample of Portuguese older adults with mild-to-moderate cognitive impairment. Clinicians assessed for major depressive disorder and cognitive functioning in 117 participants with mild-to-moderate cognitive decline (76.9% female, Mage = 83.66 years). The internal consistency of GDS-27 and GDS-15 were 0.874 and 0.812, respectively. There was a significant correlation between GDS-27 and GDS-15 with the Beck Depression Inventory-II (GDS-27: rho = 0.738, p < 0.001; GDS-15: rho = 0.760, p < 0.001), suggesting good validity. A cutoff point of 15/16 in GDS-27 and 8/9 in GDS-15 resulted in the identification of persons with depression (GDS-27: sensitivity 100%, specificity 63%; GDS-15: sensitivity 90%, specificity 62%). Overall, the GDS-27 and GDS-15 are reliable and valid instruments for the assessment of depression in Portuguese-speaking older adults with cognitive impairment.

Epidemiological characteristics and hospitalization trajectories prior to suicide in Galicia between 2013 and 2016.

INTRODUCTION: Addressing suicide requires an understanding of regional patterns of epidemiology, with health variables being central. However, the clinical profile of people who commit suicide has received little attention. The objectives of this study were to analyze the sociodemographic, clinical, and forensic characteristics of persons who committed suicide in Galicia between 2013 and 2016, analyze suicide mortality rates, and identify trajectories of hospitalizations and associated variables. MATERIAL AND METHODS: A population study was carried out on the 1354 people who died by suicide in Galicia. RESULTS: The most common profile was a retired man, 57.9 years old (SD=18.5), from an urban and inner area. 43.6% had been previously hospitalized, 41.6% had been diagnosed with physical disorders, and 26.8% with mental disorders. 48.2% had been prescribed psychiatric medications and 29.6% had received outpatient psychiatric care. The highest prevalence of death by suicide (27.5%) was in 2014, with the predominant method being hanging (59.1%). The average raw rate was 12.3/100,000. Three trajectories of hospitalizations emerged: 94.83% had experienced few hospitalizations; 2.95% an increasing pattern; and 2.22% a decreasing pattern. These trajectories were associated with number of psychiatric appointments, prescription of psychiatric medications, and diagnoses of physical and mental disorders. CONCLUSIONS: These findings are crucial for detection and prevention.

Gender-based violence and mental disorders in female college students.

PURPOSE: To assess the association between gender-based violence and DSM-IV Axis I disorders in female college students. METHODS: A stratified random sample of 1,043 college women (average age 22.2 years) participated in the study. We collected sociodemographic, socioeconomic and academic information as well as information on the participants' experience of gender-based violence victimization. The presence of mental disorders during the 12 months preceding the study was assessed by clinically trained interviewers applying the Structured Clinical Interview for DSM-IV Axis I disorders-Clinician Version (SCID-CV). RESULTS: 15.2% of the participants reported lifetime gender-based violence victimization. Almost two-thirds of the victims had suffered some Axis I disorder during the past year, a significantly larger proportion than among non-victims (OR = 3.72; 95% CI 2.61-5.30). Mood disorders and anxiety disorders were both significantly more common among victims than non-victims (OR = 4.26; 95% CI 2.81-6.46 and OR = 1.97; 95% CI 1.20-3.24, respectively). The most prevalent individual disorder among victims was major depressive disorder (26.41%). Among victims of purely psychological violence, the overall rate of Axis I disorder was similar to the rate among other victims (67 and 61%, respectively). CONCLUSIONS: Among female university students, the experience of physical or psychological gender-based violence is associated with mental disorder. These findings suggest the need for treatment and prevention interventions designed specifically for this population.

Quality of Life and Sexual Satisfaction in Women with Breast Cancer Undergoing a Surgical Treatment and in Their Male Partners.

This study aimed to determine the quality of life and sexual satisfaction in a sample of 389 women with breast cancer who underwent a surgical treatment and 366 men who were these women's partners. The sample was recruited from the Portuguese League Against Cancer by 10 trained psychologists who assessed the quality of life and sexual satisfaction of the participants. Data on the sociodemographic variables, diagnosis and treatment in the female participants, relationship with their partner, anxiety and depression, and body image were also collected. It was found that 76.6% and 54.2% of the women had low physical and mental health, respectively, while 100% of partners had acceptable physical and mental health. The predictors of women's physical health were months since surgery, current treatment, completed treatments, satisfaction with the current relationship with their partner, lower anxiety and depression, and better body image. The predictors of women's mental health were months since diagnosis and treatment completion, satisfaction with partner support during the illness, lower anxiety and depression, and better body image. The predictors of both physical and mental health of partners were lower anxiety and depression. In addition, 88.4% of women and 100% of partners presented with sexual dysfunction. The predictors of women's sexual satisfaction were being older, satisfaction with their relationship with their partner before the illness, lower anxiety and depression, and better body image. The predictors of sexual satisfaction of the male partners were psychological/psychiatric support, satisfaction with their current relationship with their partner, and lower anxiety and depression. These findings suggest that interventions targeted at the quality of life of women and sexual satisfaction with a couple perspective are needed.

Prevalence and Associated Factors with Poor Sleep Quality in Non-Professional Caregivers.

This study aimed to determine the prevalence and associated factors of poor sleep quality in non-professional caregivers. With this purpose, cross-sectional data were collected from 201 dependent people's family caregivers using the Pittsburgh Sleep Quality Index (PSQI), the Caregiver Burden Inventory (CBI), the General Health Questionnaire (GHQ-12), and an ad hoc questionnaire to obtain sociodemographic data. A total of 153 family caregivers were categorized as poor sleepers (PSQI > 5), resulting in a prevalence of poor sleep quality of 76.1% (95% CI = 70.5-82.5). Poor sleepers were more likely to care for persons with mental disorders (χ2 = 7.31; p < 0.01) and scored significantly higher on perceived burden (z = -4.44; p < 0.001), psychological distress (z = -6.24; p < 0.001), and in all the PSQI subscales (p < 0.001), compared with good sleepers (PSQI ≤ 5). By contrast, no differences were found between poor and good sleepers in age, gender, years providing care, and daily hours of care. Multiple linear regression analysis showed that the factors of caregiver burden (ß = 0.15; p < 0.05) and psychological distress (ß = 0.53; p < 0.001) were significantly associated with sleep quality in dependent people's family caregivers. Cognitive-behavioral strategies to improve sleep quality in the primary health care of family caregivers are suggested.

Sexual Victimization and Mental Health in Female University Students.

Although sexual assaults on female university students are a public health concern, studies that have examined this issue have not used behaviorally specific definitions of the various types of sexual victimization. Furthermore, hardly any data exists on female Spanish university students. The objectives of this study were to analyze the prevalence of different forms of sexual assault against female Spanish university students, determine the risk factors associated with sexual assault, analyze the association between sexual victimization and mental health problems, and determine the differential risk of more serious types of sexual assault. A cross-sectional study was conducted among a random sample of 871 students from the University of Santiago de Compostela (Spain) (mean age 20.7 years, SD = 2.8). The current study assessed various types of sexual violence (i.e., unwanted sexual contact, attempted coercion, coercion, attempted rape, rape), as well as rates of depression, anxiety, stress, eating disorders, substance abuse, suicide risk, and suicide attempts. Of the female students surveyed, 28.5% had suffered some form of sexual violence during the previous year, 22.3% reported unwanted sexual contact, 8.8% attempted coercion, 6.5% coercion, 10.4% attempted rape, and 7.9% had been raped. Lower risk was associated with having a partner and being heterosexual. Being 18 years of age and prior experiences of sexual victimization were associated with higher risk. Being the victim of attempted coercion was associated with a higher risk of depression, while victims of attempted rape were at higher risk for substance use. Rape victims were at the highest risk for all mental health conditions studied, with the exception of suicide attempts. Due to the high rates at which Spanish female university students experience sexual violence, planning and resources are needed to address their mental health needs, especially those who are victims of rape.

Factorial Structure and Psychometric Properties of the Spanish Version of the Pittsburgh Sleep Quality Index in Non-Professional Caregivers.

Although sleep issues are among the symptoms commonly experienced by the non-professional caregiver population, and the Pittsburgh Sleep Quality Index (PSQI) is the most widely used instrument for the assessment of sleep quality, this has not been validated specifically for this population. The objective of this study was to analyze the factorial structure and psychometric properties of the Spanish version of the PSQI in a sample of Spanish non-professional caregivers. Trained clinical psychologists assessed sleep quality using the PSQI, as well as caregiver burden and psychological distress in 201 non-professional caregivers (87.1% female, Mage = 56.2 years). The internal consistency of the PSQI was 0.75. The two-factor model (Sleep quality and Disturbances) had an acceptable fit to the data, was found to be superior to the one-factor model, and more parsimonious than the three-factor model. There was a significant correlation between the PSQI and caregiver burden, as well as between the PSQI and psychological distress (p < 0.001 in all cases). A total score ≥ 9 allowed the identification of caregivers with possible anxiety and depression disorders (sensitivity 70.5%, specificity 71.9%). The results show that the PSQI is a reliable and valid instrument for the assessment of sleep quality in caregivers.

Sleep Disturbance, Psychological Distress and Perceived Burden in Female Family Caregivers of Dependent Patients with Dementia: A Case-Control Study.

This case-control study analyzed the sleep disturbance, psychological distress and perceived burden in female family caregivers of dependent people with dementia (n = 74) compared with female family caregivers of dependent people without dementia (n = 74) and with age-matched non-caregiver control females (n = 74). Participants completed the Pittsburgh Sleep Quality Index (PSQI), the 12-item General Health Questionnaire (GHQ-12), the Caregiver Burden Inventory (CBI) and an ad hoc questionnaire to collect sociodemographic data. There were significant differences between the groups in PSQI total (F = 24.93; p < 0.001), psychological distress (F = 26.71; p < 0.001) and in all sleep domains assessed: subjective sleep quality (F = 16.19; p < 0.001), sleep latency (F = 9.5; p< 0.001), sleep duration (F = 18.57; p < 0.001), habitual sleep efficiency (F = 19.77; p < 0.001), sleep disturbances (F = 9.22; p < 0.001), use of sleep medications (F = 4.24; p< 0.01) and daytime dysfunction (F = 5.57; p < 0.01). In all measures, the female family caregivers of dependent people with dementia showed the significantly higher mean scores. Regarding the two groups of female caregivers, statistically significant differences were found in daily hours of care (t = −2.45; p < 0.05) and perceived burden (t = −3.65; p < 0.001), as well as in the following dimensions of caregiver burden: time-dependence burden (t = −5.09; p < 0.001), developmental burden (t = −2.42; p < 0.05) and physical burden (t = −2.89; p < 0.01). These findings suggest that female family caregivers of dependent patients with dementia should be subject to psychopathological screening and preventive cognitive-behavioral interventions in clinical practice in primary health care.