ArticleSocial psychiatry and psychiatric epidemiology2026
Prevalence and associated factors of burden, depression, and anxiety among informal caregivers of individuals with severe mental disorders within the '686 program': a community-based cross-sectional study.
Article in Social psychiatry and psychiatric epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Aging while caregiving: a life course qualitative study of left-behind older parents caring for adult children with schizophrenia in rural China.International journal for equity in health · 2026Article
- Caregiver Mental Health and Sociodemographic Factors Associated with the Burden of Care in Taiwan Among Primary Caregivers of Patients with Major Depressive Disorder: A Cross-Sectional Study.Neuropsychiatric disease and treatment · 2026Article
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9 authors.
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Abstract
backgroundInformal caregivers play a vital role in the long-term community care of individuals with severe mental disorders but often face substantial psychological challenges. China's national '686 Program' offers free or subsidized medical treatment, follow-up care, and community-based services for people with severe mental disorders on an equitable basis. However, limited evidence exists regarding the mental health status of informal caregivers within this program. This study aimed to assess the prevalence of high caregiver burden, depression, and anxiety, and to identify associated factors among informal caregivers enrolled in the '686 Program'.
methodsA cross-sectional study was conducted in Hainan Province, China, involving 284 informal caregivers recruited through multistage sampling. Data were collected via structured, face-to-face, in-home interviews between May and September 2024. Caregiver burden, depression, and anxiety were assessed using the 12-item Zarit Burden Interview (ZBI-12), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7), respectively. Binary logistic regression analyses-together with prespecified stratified and sensitivity analyses-were conducted to identify independent predictors of each outcome.
resultsAmong the 284 participants, 63.7% experienced high caregiver burden, 11.6% met criteria for clinically significant depression, and 17.6% for clinically significant anxiety. Multivariate analysis showed that higher PANSS scores and greater social disability (SDSS) in care recipients were the most consistent predictors across outcomes. Depression was independently associated with being female, having a parental relationship to the patient, and caring for individuals with greater functional impairment; longer illness duration (≥ 11 years) was linked to lower risk. Anxiety was more likely among female caregivers and those supporting patients with more severe symptoms. Diagnostic heterogeneity did not materially alter these associations in sensitivity analyses.
conclusionInformal caregivers under China's '686 Program' experience high rates of burden, depression, and anxiety. Key associated factors include patient symptom severity, caregiver gender, and the caregiving relationship. By focusing on caregivers within a national mental health initiative, this study provides evidence to inform caregiver support strategies both in China and in similar global contexts pursuing community-based mental health reforms. These findings highlight that structural equity in patient services alone is insufficient unless caregiver needs are explicitly incorporated into system design.
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