The Burden of Caring for Dependent Older People and the Resultant Risk of Depression in Family Primary Caregivers in Italy

Round 1

Reviewer 1 Report

This manuscript deals with an interesting and topical subject, the burden of caring for dependent older people and the resultant risk of depression in family primary care givers in Italy. The manuscript is well written. However, the reviewer would like to ask the authors to make it clear why you choose Italy as your case subject (line 44) and why a case study in a region in Italy can be applied for internationally the whole Europe (line 493)? There are a lot of varieties in nationality of people and social welfare system for seniors in European countries.

Author Response

please  see in the attached file 

Author Response File: Author Response.pdf

Reviewer 2 Report

This is my report for the mansucript entitled "The Burden of Caring for Dependent Older People and the Resultant Risk of Depression in Family Primary Caregivers in  Italy"

The topic of the manuscript is really relevant and there is an obvious need for such types of researches as population of Developed World is getting older every year.

Although this particular paper has significant drawbacks which should be addressed in order to have this manuscript published:

1. A more specified literature review is required, which would allow to clearly identify the scientific gap which this paper aims to fulfill. Maybe juxtaposing of the prevailing theoretical streams with identification of their main weaknesses would help?
2. A paper clearly lacks a more rigorious statistical techniques. The current research approach is a simple descriptive statistics of the survey data. It is clearly to weak for the robust research.
3. As there are no serious research methods applied, the robustness of the findings cannot be checked, so the relevance of the conslusions remains questionable.

Author Response

please see in the attached file 

Author Response File: Author Response.pdf

Reviewer 3 Report

From my perspective, researching on the mental health issues and risk of depression among caregivers of older adults is essential and impactful. 

I would like to point out a few organization and data analysis issues below,

1. Put in subtitles for the introduction session, so it could better aligned with the four aims of the study.
2. Organization of the result session: I would suggest putting the description of characteristics of the caregivers with depressive symptoms and the experience of caregivers children and spouse forward, before the illustration of the binary regression (or the results of the relationship between the potential factors and depression). It is because giving the description results beforehand let readers be more familiar and having a more clear knowledge of what are those "perceived burdens" , thus allowing the readers to acknowledge the factors correlated with depression.
3. The presentation of the binary logistic regression results: Firstly, you are required to do a correlation before doing the binary logistic regression, so at least need to show their correlation are significant in order to perform the regression. Secondly, the subtitles of Table 2 is not clear in showing the results of the regression, especially the beta coefficient. Thirdly, how about the variables such as social support, quality of life ... these will affect the risk of depression as well I believe.

I think the presentation of the results is the major issue of the paper, while with the revision, it is worth publishing.  

Author Response

Plase see the attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

The changed made by authors are not significant and can be cinisdered shallow. Authors did not use a possibility to substantially improve the paper.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 3 Report

The authors were able to response to my concern, and I advise to accept this manuscript for publication.