Poor mental health days and depressive disorders comparing non-caregivers, informal non-cancer caregivers, and informal caregivers of cancer patients: BRFSS 2022-23.
Ward J, Blosnich J, Champion V • Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer • 2026
Informal cancer caregivers had significantly higher odds of frequent mental distress days than non-caregivers (aOR=1.89), while cancer caregiving was more strongly associated with frequent mental distress than with lifetime depression.
Key Findings
Results
Informal cancer caregivers had significantly higher adjusted odds of frequent mental distress days (FMD) compared to non-caregivers.
Adjusted odds ratio for FMD among informal cancer caregivers vs. non-caregivers was aOR=1.89 (95% CI=1.58-2.26)
FMD was defined as reporting ≥6 days of poor mental health in the last 30 days
The model adjusted for sociodemographics, year, U.S. region, physical health (≥14 poor physical health days monthly), and exercise
Sample included informal cancer caregivers (n=3,078), informal non-cancer caregivers (n=39,047), and non-caregivers (n=157,539)
Data were drawn from 2022 and 2023 BRFSS surveys across 24 states administering the caregiving module
Results
Informal non-cancer caregivers had significantly higher adjusted odds of a lifetime depression diagnosis compared to non-caregivers.
Adjusted odds ratio for lifetime depression diagnosis among informal non-cancer caregivers vs. non-caregivers was aOR=1.44 (95% CI=1.36-1.52)
This association was statistically significant after adjusting for sociodemographics, year, U.S. region, physical health, and exercise
Non-cancer caregivers represented the largest caregiver group with n=39,047 participants
Results
Cancer caregiving was more strongly associated with frequent mental distress than with lifetime depression diagnosis.
The pattern of findings differed between the two mental health outcomes: cancer caregivers showed a stronger signal for FMD rather than lifetime depression
This suggests cancer caregiving may be associated with acute or episodic mental distress rather than a chronic depressive disorder
The authors note this distinction has implications for when and how to screen caregivers for mental health needs
Results
In unadjusted comparisons, informal caregivers differed significantly from non-caregivers across several sociodemographic and health characteristics.
Informal caregivers were more likely to report FMD or a lifetime depression diagnosis than non-caregivers in unadjusted analyses
Unadjusted comparisons showed significant differences across sociodemographic variables including age, sex, marital status, education, employment, and rural/urban status
These differences highlight the importance of adjustment for confounders when comparing caregiver and non-caregiver mental health outcomes
Methods
The study used logistic regression models with covariates including physical health days, exercise, age, sex, marital status, education, employment, and rural/urban status, adjusted for U.S. region and year.
Outcomes modeled were frequent mental distress days (FMD; ≥6 days of poor mental health in the last 30 days) and lifetime depression diagnosis
Physical health was measured as reporting ≥14 poor physical health days monthly
Exercise was captured as any exercise in the previous month
Data came from 24 states that administered the BRFSS caregiving module in 2022 and 2023
Total analytic sample was 199,664 respondents across three groups
What This Means
This research suggests that people who informally care for cancer patients—such as family members or friends providing unpaid care—experience notably higher levels of frequent mental distress compared to people who are not caregivers, even after accounting for differences in age, health, employment, and other factors. Specifically, cancer caregivers were nearly twice as likely as non-caregivers to report having six or more days of poor mental health in a given month. Interestingly, this heightened mental distress did not translate as strongly into a lifetime diagnosis of depression, suggesting that the mental health burden of cancer caregiving may be more acute and situational rather than a long-standing condition.
The study also found that people caring for individuals with non-cancer conditions had significantly higher rates of lifetime depression diagnosis compared to non-caregivers, though their pattern of mental health challenges differed from cancer caregivers. These findings were based on a large national survey of nearly 200,000 U.S. adults across 24 states in 2022 and 2023, making it one of the more comprehensive examinations of this topic.
This research suggests that healthcare systems could benefit from routinely screening informal caregivers—particularly those caring for cancer patients—for mental health distress during clinical visits. Because cancer caregiving appears linked to episodic rather than chronic mental health struggles, timely identification and support during periods of high caregiving burden may be especially important for preventing worsening outcomes for both caregivers and the patients they support.
Ward J, Blosnich J, Champion V. (2026). Poor mental health days and depressive disorders comparing non-caregivers, informal non-cancer caregivers, and informal caregivers of cancer patients: BRFSS 2022-23.. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. https://doi.org/10.1007/s00520-026-11337-y