Umer Madeha, Tong Ho Yi Co Co, Rodak Terri, Xu Changjun, Dennis Cindy Lee, Naeem Farooq, Mulsant Benoit, Husain Muhammad Ishrat
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
J Affect Disord. 2025 Apr 1;374:191-215. doi: 10.1016/j.jad.2024.12.109. Epub 2025 Jan 2.
Bipolar disorder (BD) imposes significant social, psychological, and economic burdens on individuals and their caregivers. While developing treatments for BD patients is crucial, supportive interventions for caregivers in low- and middle-income countries (LMICs) are equally important, given the limited resources and healthcare infrastructure. Understanding caregiver experiences in these settings is essential for creating effective interventions. This scoping review synthesizes knowledge of caregiver experiences in assisting individuals with BD in LMICs.
Following Arksey and O'Malley's scoping review framework, we examined quantitative and qualitative studies on caregiver experiences. A comprehensive literature search was conducted across five databases, with two authors independently screening studies, extracting data, and reviewing references for additional eligible studies. Findings are presented through narrative synthesis according to PRISMA-ScR guidelines.
Out of 3518 records, 104 studies met the eligibility criteria. Five main themes and eight subthemes were identified: (1) burden of caregiving (impaired quality of life), (2) caregiver challenges (lack of understanding, family/social disruptions, financial restraints, mental and physical fatigue), (3) caregiver needs (information access, involvement, social support, financial assistance), (4) coping mechanisms, and (5) the silver lining in caregiving.
This review highlights significant challenges faced by caregivers of individuals with BD in LMICs, emphasizing the need for better psychoeducation, healthcare communication, and supportive resources. Addressing financial constraints and stigma is also crucial. Future research should focus on culturally adapting evidence-based strategies to support caregivers in these settings.
双相情感障碍(BD)给患者及其照料者带来了巨大的社会、心理和经济负担。虽然为双相情感障碍患者开发治疗方法至关重要,但鉴于中低收入国家(LMICs)资源有限和医疗基础设施薄弱,为照料者提供支持性干预同样重要。了解这些环境下照料者的经历对于制定有效的干预措施至关重要。本范围综述综合了中低收入国家照料者在协助双相情感障碍患者方面的经历的相关知识。
遵循阿克西和奥马利的范围综述框架,我们研究了关于照料者经历的定量和定性研究。在五个数据库中进行了全面的文献检索,由两位作者独立筛选研究、提取数据并查阅参考文献以寻找其他符合条件的研究。根据PRISMA-ScR指南通过叙述性综合呈现研究结果。
在3518条记录中,104项研究符合纳入标准。确定了五个主要主题和八个子主题:(1)照料负担(生活质量受损),(2)照料者面临的挑战(缺乏理解、家庭/社会关系破裂、经济限制、身心疲劳),(3)照料者的需求(获取信息、参与、社会支持、经济援助),(4)应对机制,以及(5)照料中的积极方面。
本综述强调了中低收入国家双相情感障碍患者照料者面临的重大挑战,强调需要更好的心理教育、医疗沟通和支持资源。解决经济限制和污名化问题也至关重要。未来的研究应侧重于在文化上调整基于证据的策略,以支持这些环境下的照料者。