Effectiveness of psychosocial interventions addressing informal caregivers' mental health: an umbrella systematic review with 26,481 participants

Aim: We aimed to provide a comprehensive overview of the effectiveness of psychosocial interventions on informal caregivers' mental health, organized by the clinical condition(s) of the care recipient. Methods: We conducted an umbrella systematic review and random-effects meta-analyses to pool the results of the included studies for each combination of clinical condition, intervention type, comparison and outcome. Results: We included 19 systematic reviews and 50 meta-analyses, with 26,481 participants. Several interventions improved mental health outcomes in caregivers, and across various clinical conditions of the care recipients. In dementia caregivers, multicomponent interventions significantly reduced depressive and anxiety symptoms, and caregiver burden (SMD from -0.65 to -0.19). For caregivers of people with lung cancer, psychoeducation and psychological support reduced depressive (SMD = -1.66, 95% CI -3.19 to -0.13) and anxiety symptoms (SMD = -1.37, 95% CI -2.54 to -0.21). Multicomponent interventions reduced depressive and anxiety symptoms in parents of children with cancer (SMD = -0.38, 95% CI -0.64 to -0.12; SMD = -0.89, 95% CI -1.33 to -0.45). Caregiver burden of caregivers of people with psychosis and schizophrenia decreased after psychoeducation and skills-training (SMD = -2.10, 95% CI -3.46 to -0.74; SMD = -0.94, 95% CI -1.72 to -0.17). Certainty of evidence was low to moderate, and the strength of association was overall weak. Conclusions: We rigorously assessed the quality, certainty of evidence, and the strength of associations. Despite the appraisals highlighting the need for further high-quality research, our results can inform policy and practice on the use of psychosocial interventions for caregivers of people with different clinical conditions.