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EV0215

Factors associated with primary caregivers’ responses, attitudes, and understanding regarding adolescent depression in Sarawak

FACTORS ASSOCIATED WITH PRIMARY CAREGIVERS' REACTIONS, ATTITUDES, AND UNDERSTANDING OF ADOLESCENT DEPRESSION IN SARAWAK

Although support was the highest-scoring dimension of caregiver responses in Sarawak, affiliate stigma and place of residence emerged as major determinants of caregiver responses.

The aim was to examine factors associated with primary caregivers’ responses, attitudes, and understanding of adolescent depression among caregivers of adolescents receiving treatment for depression in Sarawak. This cross-sectional study, conducted using purposive sampling at six psychiatric centers in Sarawak between January and November 2025, included 212 primary caregivers of adolescents aged 10–19 years. An online, self-administered questionnaire collected sociodemographic data and included the Malay version of the Parental Responses, Attitudes, and Understanding of Adolescent Depression scale (M-PRAUD; 23 items, 5 domains) and the Affiliate Stigma Scale (ASS-M; 21 items, 4 domains). Data were analyzed using descriptive statistics, correlation analysis, and multiple linear regression. Participants had a mean age of 46.2 years; 74.5% were women, 25.5% were men, and 90.6% lived in urban areas. Among the M-PRAUD domains, support had the highest mean score (17.51 ± 2.73), followed by overprotectiveness (14.75 ± 4.25) and criticism (12.31 ± 4.25); distress (8.61) and overcontrolling behavior (8.09) had lower scores. The overall ASS-M score was 35.11 ± 11.42. In the regression analysis, affiliate stigma was associated with lower support (beta = -0.30; p < 0.001) and greater distress (beta = +0.37; p < 0.001); male sex was associated with lower support (beta = -0.27; p < 0.001); and urban residence was associated with less overcontrolling behavior (beta = -0.20; p = 0.003) and lower distress (beta = -0.22; p = 0.001). Having more children was associated with overcontrolling behavior at beta = -0.23 (p = 0.001) and distress at beta = +0.16 (p = 0.026). In conclusion, although caregivers were generally supportive, criticism and distress reflected underlying strain; improving mental health literacy and reducing stigma, particularly in rural areas, may improve the management of adolescent depression.

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