Caregiver burden among caregivers of patients with depression: a systematic review and meta-analysis
TL;DR
It is proposed that public health interventions targeting mental health indicators and social support systems should be implemented for informal caregivers of individuals with depression, with the objectives of reducing the caregiving burden of this population and potentially improving the quality of care accessed by patients with depression.
Abstract
Background Depression is a highly prevalent mental disorder with a global distribution. Informal caregivers are integral to the long-term care of individuals with depression. However, they frequently experience substantial caregiver burden, detrimentally impacting both caregiver well-being and patient prognosis. Despite the clinical significance of this issue, there is currently no systematic review or meta-analysis quantifying the overall magnitude of this burden and synthesizing its associated factors among informal caregivers of patients with depression. Objective This study aimed to assess the level of caregivers’ burden among informal caregivers who are taking care of patients with depression and to systematically evaluate the associated factors through a narrative synthesis guided by the Stress-Appraisal Model. Methods Eight electronic databases (PubMed, MEDLINE, Embase, PsycINFO, Web of Science, CNKI, Wan fang, and VIP) were systematically searched. Data extraction and quantitative synthesis were performed using STATA version 18.0. Statistical heterogeneity was assessed via Cochran’s Q test and the I2 statistic, followed by robust sensitivity and subgroup analyses. Concurrently, a narrative synthesis guided by the Stress-Appraisal Model was conducted to systematically identify associated factors, providing a theoretical basis for future targeted interventions. Results The current systematic review and meta-analysis comprised all 1366 research respondents from 11 studies. The overall pooled mean score of caregiver burden was 38.15 (95% CI: 31.38, 44.92; I2 = 98.9%, p < 0.001) with a 95% prediction interval ranging from 19.67 to 56.67. Subgroup analyses indicated no significant differences based on patient type or country. However, caregivers of patients with severe depression exhibited a higher pooled mean burden 42.40 (95% CI: 29.85, 54.94) compared to those caring for patients with moderate depression 35.51 (95% CI: 22.74, 48.28). Furthermore, a disease course exceeding one year yielded a higher caregiver burden 39.26 (95% CI: 33.34, 45.18) than a duration of less than one year 34.42 (95% CI: 27.84, 40.99). Conclusion The current systematic review and meta-analysis showed that caregivers of patients with depression generally experience substantial caregiving burden, with pooled effect estimates indicating that the overall severity of this burden approaches the moderate level. Nevertheless, due to the limited quantity of caregiving burden is affected by multiple clinical variables. Accordingly, the findings of current systematic reviews should be interpreted with caution. Furthermore, this study proposes that public health interventions targeting mental health indicators and social support systems should be implemented for informal caregivers of individuals with depression, with the objectives of reducing the caregiving burden of this population and potentially improving the quality of care accessed by patients with depression. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD420261373459, identifier CRD420261373459.