Factors associated with anxiety and depression among caregivers of children with non-communicable diseases in Bangladesh: A cross-sectional study at Bangladesh Medical University

Abstract

Background: Non-communicable diseases (NCDs) in children require long-term care that causes physical, emotional and financial burdens on families. The mental health of caregiver is still underexplored in the Bangladeshi context even though their psychological well being directly affects the quality of care a child receives as well as overall functioning of the family.. Objectives: To assess the mental health status of caregivers of children with NCDs and identify the socio-demographic and disease-related factors associated with anxiety and depression. Methods: A hospital-based cross-sectional study was conducted at the Department of Paediatrics, Bangladesh Medical University, between January to June 2026. A total of 310 primary caregivers of children under 18 years diagnosed with thalassemia, congenital heart disease, nephrotic syndrome, bronchial asthma, type 1 diabetes mellitus and epilepsy were recruited through convenience sampling. Anxiety and depression were assessed using the GAD-7 and PHQ-9, with a cut-off of ≥ 10 indicating clinically significant symptoms. Data were analyzed in STATA 17.0 using chi-square tests and multivariable logistic regression (p <0 .05). Results: Most respondents were female (77%), mothers (76%), housewives (67%), and aged over 30 years (53%); 65% earned less than BDT 25,000 per month and 44% cared for children aged five years or younger. Overall, 61% of caregivers screened positive for anxiety and 60% for depression. In the multivariable analysis, financial stress was the strongest independent predictor of both anxiety (AOR = 4.94, 95% CI: 2.37–10.33) and depression (AOR = 4.67, 95% CI: 2.31–9.45). Caregivers of children aged five years or younger had over seven times higher odds of anxiety (AOR = 7.33) and over three times higher odds of depression (AOR = 3.40). Mothers had twice the odds of depression compared to fathers (AOR = 2.14), and caregivers in the lowest income group had five times higher odds of anxiety (AOR = 5.01). Conclusions: Three out of five caregivers of children with NCDs in experience clinically significant anxiety or depression. Financial stress, young child age and being the mother are key independent predictors. Routine caregiver mental health screening and combined clinical and financial support should be integrated into paediatric NCD services.