Department of Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.
WHO Collaborating Centre for Research and Training, Naples, Italy.
Eur Psychiatry. 2023 Nov 24;66(1):e98. doi: 10.1192/j.eurpsy.2023.2472.
Severe mental disorders - such as schizophrenia, bipolar disorder, and substance use disorders - exert a negative impact not only on affected people but also on their carers. To support carers of people with severe mental disorders, several psychosocial interventions have been developed.
This systematic review and meta-analysis aimed to assess whether psychosocial interventions for carers of persons with schizophrenia, bipolar disorder, or substance use disorders produce benefit/harm with respect to a series of outcomes - including subjective and objective burden, depressive symptoms, well-being/quality of life, sleep, skills/knowledge, self-efficacy, physical health - as compared to standard support/support as usual or other control conditions.
In carers of persons with schizophrenia, psychoeducational interventions were associated with significant improvement in personal burden, well-being, and knowledge about the illness; and a supportive-educational intervention with an improvement in personal burden. In carers of persons with bipolar disorder, psychoeducational interventions were associated with significant improvement in personal burden and depressive symptoms; family-led supportive interventions with an improvement in family burden; family-focused intervention and online "mi.spot" intervention with a significant reduction in depressive symptoms. Psychosocial interventions used for carers of persons with substance use disorders were found to be overall effective on the level of well-being, but the low number of trials did not allow detection of differences between the various psychosocial interventions.
The quality of the evidence ranged from very low to moderate, suggesting the need for further better-quality research.
严重精神障碍 - 如精神分裂症、双相情感障碍和物质使用障碍 - 不仅对患者本身，而且对他们的照顾者也会产生负面影响。为了支持严重精神障碍患者的照顾者，已经开发了几种心理社会干预措施。
本系统评价和荟萃分析旨在评估针对精神分裂症、双相情感障碍或物质使用障碍患者的照顾者的心理社会干预措施在一系列结果方面是否有益/有害 - 包括主观和客观负担、抑郁症状、幸福感/生活质量、睡眠、技能/知识、自我效能、身体健康 - 与标准支持/常规支持或其他对照条件相比。
在精神分裂症患者的照顾者中，心理教育干预与个人负担、幸福感和对疾病的认识的显著改善相关；支持性教育干预与个人负担的改善相关。在双相情感障碍患者的照顾者中，心理教育干预与个人负担和抑郁症状的显著改善相关；家庭主导的支持性干预与家庭负担的改善相关；以家庭为中心的干预和在线“mi.spot”干预与抑郁症状的显著减少相关。用于物质使用障碍患者照顾者的心理社会干预措施在整体幸福感方面被发现是有效的，但试验数量较少，无法检测各种心理社会干预措施之间的差异。
证据质量从极低到中等不等，表明需要进一步开展高质量的研究。
