Effectiveness of psychological interventions for carers of patients with severe mental illness (SMI): a systematic review

Abstract

Objectives Interventions for carers of patients with severe mental illness (SMI) are effective in improving patient outcomes. This review examined the effectiveness of psychological interventions or support designed to help carers of patients with SMI.Design A systematic review of randomised controlled trials (RCTs) was conducted. Study selection, data abstraction and risk of bias assessments were independently conducted and duplicated. The reporting of this review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Data sources CINAHL, CENTRAL, EMBASE, Medline and PsycINFO were searched from inception to 30 April 2024.Eligibility criteria Only studies using an RCT were considered. All other research designs were excluded. The included population was carers over 18 caring for a patient with SMI. Any psychological, psychosocial or psychoeducational interventions were included. Patients under 18, diagnosed with dementia or learning disabilities comorbidity, were excluded.Data extraction and synthesis Study characteristics and outcome data (mean and SD) for each included study were collected. Review Manager (RevMan) was used to manage the data. Meta-analysis was not considered appropriate due to the heterogeneity of the included studies. The results were presented as a narrative synthesis.Results This review included 3869 participants from 32 RCTs and demonstrated a beneficial effect of psychological interventions for carers. Psychoeducation was widely used and the most evaluated intervention for carers.Conclusions Psychological interventions for carers are beneficial in helping to reduce negative outcomes and enhance positive outcomes. Future research could focus on exploring the impact of interventions on less evaluated outcomes such as depressive and anxiety symptoms.PROSPERO registration number CRD42021233181.