DefinePK

Abstract

Background: Mood disorders, particularly Bipolar I and Bipolar II disorders, are chronic psychiatric conditions that not only impair the lives of affected individuals but also impose substantial psychological strain on their caregivers. Although caregiver burden is well-documented in psychiatric research, limited attention has been given to the differential distress experienced by caregivers of patients with Bipolar I versus Bipolar II, particularly within culturally specific, resource-constrained settings such as Pakistan.
Objective: This study aimed to compare the levels of psychological distress—operationalized as depression, anxiety, and stress—between caregivers of patients with Bipolar I and Bipolar II disorders in Pakistan, and to explore the mediating role of anxiety in the relationship between stress and depression.
Methods: A cross-sectional correlational design was employed, using purposive sampling to recruit 384 caregivers—192 of patients diagnosed with Bipolar I and 192 with Bipolar II. Participants were assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Independent samples t-tests, Pearson’s correlation, and mediation analysis through Hayes’ Process Macro version 4.1 (Model 4) were applied using SPSS.
Results: The mean age of participants was 38.23 years (SD = 10.40). Strong positive correlations were observed among depression, anxiety, and stress in both groups. Women caregivers reported higher depression (M = 12.75, SD = 6.53) and anxiety (M = 8.68, SD = 6.64), while men had higher stress (M = 7.95, SD = 5.51). Caregivers of Bipolar II patients showed significantly higher anxiety (M = 8.29, SD = 6.43), whereas those of Bipolar I scored higher on depression (M = 10.30, SD = 5.08) and stress (M = 8.92, SD = 5.51). Mediation analysis confirmed that anxiety significantly mediated the relationship between stress and depression in both groups (p < .05).
Conclusion: This study underscores the necessity of targeted psychosocial interventions for caregivers based on bipolar subtype and gender. These findings highlight the urgent need for caregiver-focused mental health strategies in the Pakistani context.