“My child has ADHD…am I ok?” The Psychological Burden of Caring for an ADHD child in Lebanon and its association to Caregivers’ Mental Health.

Objectives: Previous studies have indicated that caregivers of ADHD children consider this disorder to be a psychological burden on their lives in all its aspects: social, occupational, and financial. As a result, these caregivers are marked with psychological morbidities including stress, anxiety and depression. While there have been reports of ADHD in Lebanon, there are no studies in Lebanon or in the Middle East that measure the psychological burden of ADHD on caregivers or its association to mental health. Therefore, this study aims to inspect the psychological burden of ADHD and assess the variation in stress, depression, and anxiety among caregivers of ADHD children. Methods: The study involves 120 Lebanese caregivers, 48 of which are caregivers of ADHD children and 72 are those of normally developing children. Caregivers are presented with three scales to report: DASS-21, SDQ and a CAPPA-adapted survey. Results: After analyzing the responses, we can infer that caregivers of ADHD children worry, avoid outside activities with their child, consider their child to be a strain on their family, on their occupation, and on their finances more than caregivers of normally developing children with ORs= 15.8, 20.3, 3.5, 13, and 3.7 respectively. Moreover, more caregivers of ADHD children reported depression (58% vs 26%) and anxiety (31% vs 14%) with higher mean scores on DASS-21 (mean= 14.98+/-6.2, p<0.001) for depression and (mean= 15.67+/- 5.02, p<0.001) for anxiety compared with caregivers of normally developing children. ORs= 4.7 and 3.7 for depression and anxiety respectively. In addition, mental health seems to be positively associated with each of the psychological burden and severity of the child’s ADHD. And in turn, the caregivers’ psychological burden is also positively associated to the child’s ADHD severity. Finally, mental health seems to be discriminant in caregiver gender, where more mothers show depression (64%), anxiety (75%) and stress (68%) than fathers of ADHD children. Conclusion: This study affirms that caring for a child with ADHD impacts the mental health of caregivers and their lives. Therefore, there are strong grounds to contemplate ways to help such a vulnerable group of caregivers in the Lebanese population.