Prevalence of Anxiety and Depression among Caregivers of Children with Autism Spectrum Disorder and Its Impact on Their Illness

Background: Caregivers of children with autism spectrum disorder (ASD) face a major psychological challenge, particularly anxiety and depression, due to the intensive and prolonged nature of caregiving. Understanding the prevalence and determinants of these conditions is crucial for designing targeted interventions that improve caregiver well-being and child outcomes.Aim: This study aimed to assess the prevalence and severity of anxiety and depression among caregivers of children with ASD.Methods: this is an analytical cross-sectional study that was conducted among 350 caregivers of children with ASD attending the psychiatry outpatient clinic at Damietta Faculty of Medicine, Al-Azhar University. Standardized tools were used, including the Gilliam Autism Rating Scale (GARS-3) for assessing ASD severity, and the Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) for evaluating caregiver mental health. Sociodemographic data and child-related clinical characteristics were also collected.Results: The study revealed high rates of psychological distress, with 52% of caregivers experiencing both depression and anxiety, 16% depression only, and 18% anxiety only. Female caregivers reported significantly higher levels of both conditions compared to males (p < 0.001). Lower income, rural residence, and divorced or widowed status were also linked to worse mental health outcomes. A strong positive correlation was observed between ASD severity and caregiver depression (r = 0.58, p < 0.001) and anxiety (r = 0.62, p < 0.001). Multivariate regression confirmed caregiver depression, anxiety, female gender, and severe functional impairment in the child as significant predictors of higher ASD severity.Conclusion: Caregivers of children with ASD in Egypt experience a high prevalence of anxiety and depression, strongly associated with child symptom severity and sociodemographic vulnerabilities.