Além da criança: saúde mental, estado nutricional e comportamento alimentar de cuidadores de crianças com Transtorno do Espectro Autista na Amazônia brasileira

Abstract

Introduction: Caregivers of children with Autism Spectrum Disorder (ASD) are exposed to intensified caregiving demands, which may negatively impact their emotional health, self-care behaviors, and nutritional status. Although evidence has demonstrated a substantial psychological burden among these caregivers, the interaction between emotional symptoms, eating behavior, and nutritional status remains underexplored, especially in contexts where these dimensions coexist in everyday life. Objective: To analyze emotional symptoms, eating behavior, and nutritional status among caregivers of children with ASD in the Brazilian Amazon region, compared with caregivers of neurotypical children. Methods: A cross-sectional study was conducted with 120 caregivers, including 80 caregivers of children with ASD and 40 caregivers in the control group, recruited from referral centers and the community. Data collection included a sociodemographic questionnaire, the Depression, Anxiety and Stress Scale (DASS-21), the Three-Factor Eating Questionnaire (TFEQ-21), and Body Mass Index (BMI) assessment. In addition, binary logistic regression analyses were performed to examine associations between emotional symptoms, eating behavior dimensions, and group membership (caregivers of children with ASD vs. control group). Results: Most caregivers were female (93.8%), with a mean age of 38 ± 7.1 years, low family income, and mean BMI of 28.0 ± 5.2 kg/m², indicating excess weight; only 21.25% reported undergoing psychotherapy. No statistically significant differences were observed between groups regarding emotional symptoms or eating behavior. Among caregivers of children with ASD, caring for a child classified as support level 2 was associated with moderate to severe stress symptoms (p = 0.011), and obesity was associated with greater severity of depressive symptoms (p = 0.022). Furthermore, stress scores (p = 0.032) and caregivers’ BMI (p = 0.035) were significant predictors of emotional eating. In the logistic regression model, depressive symptoms were associated with higher odds of belonging to the group of caregivers of children with ASD. Conclusion: Caregivers of children with ASD presented important emotional and nutritional vulnerabilities, evidenced by the association between stress, BMI, and emotional eating, as well as the relationship between obesity and greater severity of depressive symptoms. These findings reinforce the need for integrated interventions, including psychological support and nutritional follow-up, aimed at caregiver well-being and strengthening comprehensive care in the context of ASD.