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Cancer Care, Couples and Depression: New Research

Assistant Professor Kristin Litzelman shines light on depression and spouses of cancer patients

A new study from the University of Wisconsin Carbone Cancer Center highlights a troubling disparity in cancer care: the depressed spouses of cancer patients are 33 percent less likely to receive adequate treatment for depression than are patients whose spouses don’t have cancer.  In rural areas, it’s even worse: Couples who live in rural areas are 72 percent less likely to receive recommended care for depression (including medication and talk therapy) than the depressed spouses of those without cancer.

Earlier studies have shown that caregivers suffer depression at equal if not greater rates than the cancer patients themselves. That is especially concerning, says lead author Kristin Litzelman, PhD, as the mental health of caregivers affects the mental health of the patients. Cancer patient who have depressed spouses are four times more likely to develop depression themselves over the next year.

Picture of Kristin Litzelman“While caregivers may prioritize the health of their spouses over their own, earlier studies have shown that depression in patients leads to worse outcomes, so doing better to treat caregiver spouses could improve the health of both partners,’’ she says.

Litzelman, an assistant professor of human ecology, compared 225 spouses of cancer survivors to 3,678 spouses of people without cancer. All the 3,903 spouses in the study had self-reported symptoms of depression. The data came from the 2004 to 2013 editions of the Medical Expenditures Panel Survey, a nationally representative snapshot of American health.

“Caregivers might feel too busy or overwhelmed to seek help for their emotional well-being, may feel that being depressed is part of the cancer experience, or may not even realize that help is available,’’ Litzelman says. “Ultimately, though, caregivers have to take care of themselves in order to be able to care for someone else.”

Litzelman says that providers should also consider the health of the caregiver.

“Health care systems may have the opportunity to find new, innovative ways to integrate caregivers and make sure they are getting the support they need,’’ Litzelman says.

Some hospitals have begun hospital-based clinics for caregivers, so they can get help while their spouse is at appointments. The Department of Veterans Affairs offers a Family Caregiver Program, for example, as do some hospice programs.

Other UW Carbone members of the research team include Lori DuBenske, PhD, a cancer psychologist, and Amye Tevaarwerk, MD, a breast-cancer oncologist and expert in cancer survivorship.

The study was published in the Journal of General Internal Medicine and supported by grants from the American Cancer Society and the UW Carbone Cancer Center (NIH P30 CA014520).