The British Journal of Psychiatry
Mental and physical illness in caregivers: results from an English national survey sample
Lindsay Smith, Juliana Onwumere, Tom Craig, Sally McManus, Paul Bebbington, Elizabeth Kuipers
  • Declaration of interest




Caregivers make a significant and growing contribution to the social and medical care of people with long-standing disorders. The effective provision of this care is dependent on their own continuing health.


To investigate the relationship between weekly time spent caregiving and psychiatric and physical morbidity in a representative sample of the population of England.


Primary outcome measures were obtained from the Adult Psychiatric Morbidity Survey 2007. Self-report measures of mental and physical health were used, along with total symptom scores for common mental disorder derived from the Clinical Interview Schedule - Revised.


In total, 25% (n = 1883) of the sample identified themselves as caregivers. They had poorer mental health and higher psychiatric symptom scores than non-caregivers. There was an observable decline in mental health above 10 h per week. A twofold increase in psychiatric symptom scores in the clinical range was recorded in those providing care for more than 20 h per week. In adjusted analyses, there was no excess of physical disorders in caregivers.


We found strong evidence that caregiving affects the mental health of caregivers. Distress frequently reaches clinical thresholds, particularly in those providing most care. Strategies for maintaining the mental health of caregivers are needed, particularly as demographic changes are set to increase involvement in caregiving roles.

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