Morbidity patterns and mental health risks among informal caregivers: a diagnosis-based comparison with matched non-caregivers

Abstract Aim This study aims to examine differences in disease burden between informal caregivers and non-caregivers using claims data, with a particular focus on mental disorders and on characteristics related to high morbidity. Subject and methods The study applied a retrospective observational design using claims data from two major German statutory health insurance funds. We identified 139,002 informal caregivers based on caregiving-related insurance records and compared them to 272,716 insured individuals without official caregiving responsibilities. The analysis assessed morbidity based on documented diagnoses coded according to the International Classification of Diseases. Disease categories included mental and behavioral disorders, musculoskeletal disorders, cardiovascular diseases, and other major diagnostic groups. We calculated odds ratios with 95% confidence intervals using logistic regression models and additionally examined the influence of sociodemographic and care-specific variables on relevant conditions. Results Informal caregivers showed significantly higher odds of overall morbidity than non-caregivers. The analyses revealed the largest differences for mental and behavioral disorders, including depressive episodes and stress and adjustment disorders. Stress-related and mood disorders were more common among female caregivers and among caregivers whose care recipients had higher care levels. Conclusion Informal caregivers experience a higher disease burden than non-caregivers, particularly regarding mental health conditions. These findings highlight the need for targeted prevention and support strategies to reduce health risks among caregivers and to address their role as a vulnerable population in public health planning.