Little research has been carried out into determinants of both carer satisfaction in the caregiving role and how these compare with determinants of emotional distress among carers. Principal informal caregivers to 91 patients with dementing or non-dementing disorders were identified from consecutive referrals to community psychiatric nurses in an old age psychiatry service. Clinical, demographic, service and carer satisfaction variables were recorded. Emotional distress in carers was measured with the 28 item General Health Questionnaire. Dissatisfaction with caregiving was weakly correlated with emotional distress (r=0.21, p=0.042). Multiple linear regression revealed two variables which were associated with greater dissatisfaction with the caregiving role, the carers' overall rating of the degree of difficulty in the caregiving role (p<0.001) and younger age of the carer (p=0.014). Emotional distress was independently associated with the degree of difficulty in the caregiving situation (p<0.001) and inversely with the dependency of the patient on the care (p=0.038). The caregiver's assessment of the difficulty in caregiving was associated with both carer dissatisfaction and emotional distress in the caregiving role. While emotional distress was associated with the perception that the patient could do more for themselves, carer dissatisfaction was associated with younger age of the carer. There were competing demands on younger carers, particularly work. Copyright © 2000 John Wiley & Sons, Ltd.