Prevalence of depression, anxiety, stress symptoms and the related factors among caregivers of children with autism spectrum disorder in Kuantan, Pahang

Abstract

Raising a child with ASD can be very challenging for most caregivers. The demands of raising a child with autism can result in marked psychological distress for the caregivers. Studies have shown that caregivers are affected in many ways, including increased feelings of depression, anxiety and parental stress. However, there is still a lack of awareness and support resources available for raising a child with ASD. Therefore, more information is needed to translate research into practice and evidenced-based treatments. The purpose of the study is to assess the prevalence of depression, anxiety, stress symptoms and the related factors among caregivers of children with Autism Spectrum Disorder in Kuantan, Pahang. This cross-sectional study was conducted among primary caregivers of children with ASD attending National Autism Society of Malaysia (NASOM) Kuantan, psychiatry clinic and occupational therapy unit at Hospital Tengku Ampuan Afzan Kuantan and caregivers who joined PIANiS (Persatuan Ibubapa Anak Istimewa Pahang) in Kuantan, Pahang. One hundred seventy caregivers were recruited using the convenience sampling method, but only 152 participants managed to submit complete forms and were included in the data analysis. The inclusion criteria were Malaysian citizens aged 18 years old and above, able to read and understand Bahasa Malaysia and had children with ASD aged below 18 years old. The exclusion criteria were those with underlying psychiatric and chronic illnesses. Self-administered validated Malay questionnaires consisted of sociodemographic profiles, Depression Anxiety Stress Scales (DASS 21), and the Brief COPE questionnaire. The statistical analyses were done using independent t-test and chi-squared test, then proceeded with binary logistic regression. The mean age was 37.7 years old (SD=6). The majority of the participants were women (60.5%) and Malays (97.4%). The most commonly used coping strategy was engagement (M=23.1, SD=6), and the least used was disengagement (M=7.7, SD=2.4). Disengagement was the only factor significantly related to depression symptoms (AOR=1.49, CI=1.16-1.91), anxiety symptoms (AOR=1.41, CI=1.14-1.76) and stress symptoms (AOR=1.25, CI 1.01-1.55). This study shows that nearly one-sixth of the caregivers of children with ASD attending the study locations had depression, anxiety and stress symptoms. Therefore, healthcare providers should conduct more screening for depression, anxiety and stress symptoms among the caregivers of children with ASD. Psychoeducation on the appropriate use of coping strategies should be done more proactively to manage their depression, anxiety and stress symptoms in various situations.