Poor mental health days and depressive disorders by informal cancer patient caregiver status: BRFSS 2022-23

Purpose: Informal caregivers (i.e., caregivers) of cancer patients are increasing, significantly influencing patient outcomes. Caregivers face mental health issues such as depression and anxiety and factors related to caregiver burden. This study sought to elucidate whether the mental health of cancer caregivers differs from that of the general population. Methods: Data from 2022 and 2023 Behavioral Risk Factor Surveillance Surveys (BRFSS) for 24 states including the optional caregiving module were analyzed to investigate factors associated with mental health and depression, comparing cancer caregivers (n=3,078) to the general population (n=196,586). Logistic regressions identified factors associated with frequent mental distress days (FMD; > 6 days of poor mental health in the last 30 days) or a lifetime depression diagnosis. Predictors included cancer caregiver status, reporting > 14 poor physical health days monthly, exercise in the previous month, age, sex, marital status, education, employment status, rural/urban status, U.S. region, and year. Results: In unadjusted comparisons, caregivers were significantly more likely than the general population to be female, older, married/partnered, have attended college, unemployed, live rurally, and report FMD or a depression diagnosis. After adjusting for sociodemographics, year, U.S. region, physical health, and exercise, caregivers were significantly more likely than the general population to have FMD (aOR=1.69, 95%CI=1.42-2.02) or a lifetime depression diagnosis (aOR=1.22, 95%CI=1.03-1.46). Conclusion: Future research should address risk factors associated with mental health, identifying the most at-risk caregivers for targeted interventions. These findings support mental health screening of caregivers in oncology and primary care settings, especially during high-burden periods such as treatment initiation.