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May 27, 2026Open Access

Burden of Depression and Its Determinants Among Primary Caregivers of Individuals With Severe Mental Illness in Uganda: A Multicenter Cross‐Sectional Study

Key Points

This study aims to determine the prevalence of depression and its associated factors among primary caregivers of individuals with severe mental illness in Uganda.
Multicenter cross-sectional study involving 376 primary caregivers attending two regional referral hospitals in Uganda.
Data collected using standardized questionnaires including the Patient Health Questionnaire-9 for depression.
Multivariable logistic regression was used to identify factors associated with depression.
The prevalence of depression among primary caregivers was 37.8% (142/376; 95% CI: 32.7%–42.8%).
Depression was associated with high perceived stigma (aOR = 10.29, 95% CI: 3.16–33.50, p < 0.001) and low perceived social support (aOR = 10.51, 95% CI: 2.95–37.45, p < 0.001).
Caregivers of patients aged 18–44 years (aOR = 4.20, 95% CI: 1.30–13.58, p = 0.017) and those caring for patients with major depression (aOR = 7.45, 95% CI: 2.76–20.14, p < 0.001) were also at increased risk.

Abstract

ABSTRACT Background and Aims Primary caregivers of individuals with severe mental illness (SMI) often experience substantial psychological distress, yet evidence from Uganda remains limited. This study aimed to determine the prevalence of depression and its associated factors among primary caregivers of individuals with SMI in Uganda. Methods We conducted a multicenter cross‐sectional study among 376 consecutively recruited primary caregivers of individuals with SMI attending Jin[ja Regional Referral Hospital and Mbarara Regional Referral Hospital. Data were collected using interviewer‐administered questionnaires, including the Patient Health Questionnaire‐9 for depression, the devaluation of consumer families scale for perceived stigma, and the multidimensional scale of perceived social support for social support. Data were analyzed using SPSS version 22.0. Multivariable logistic regression was used to identify factors independently associated with depression, and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported. Results The prevalence of depression among primary caregivers was 37.8% (142/376; 95% CI: 32.7%–42.8%). Among caregivers with depression, 99 (69.7%) had moderate depression, 35 (24.7%) had moderately severe depression, and 8 (5.6%) had severe depression. Depression was independently associated with high perceived stigma (aOR = 10.29, 95% CI: 3.16–33.50, p < 0.001), low perceived social support (aOR = 10.51, 95% CI: 2.95–37.45, p < 0.001), caring for patients aged 18–44 years (aOR = 4.20, 95% CI: 1.30–13.58, p = 0.017), caring for patients aged 65 years or older (aOR = 8.38, 95% CI: 1.50–46.89, p = 0.016), and caring for patients with major depression (aOR = 7.45, 95% CI: 2.76–20.14, p < 0.001). Conclusion Depression was common among primary caregivers of individuals with SMI in this Ugandan multicenter study. Higher perceived stigma, lower perceived social support, and selected patient characteristics were associated with caregiver depression. These findings highlight the need for caregiver‐focused mental health screening and psychosocial support within routine psychiatric care.

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