Risk and Protective Factors for PTSD in Caregivers of Adult Patients with Severe Medical Illnesses: A Systematic Review

Abstract

Caregivers of severely ill individuals often struggle to adjust to new responsibilities and roles while experiencing negative psychological outcomes that include depression, anxiety and Post-Traumatic Stress Disorder (PTSD). This systematic review aims to outline potential risk and protective factors for the development of PTSD in caregivers of adult subjects affected by severe somatic, potentially life-threatening illnesses. Twenty-nine studies on caregivers of adult patients affected by severe, acute, or chronic somatic diseases have been included. Eligibility criteria included: full-text publications reporting primary, empirical data; PTSD in caregivers of adult subjects affected by severe physical illnesses; risk and/or protective factors related to PTSD; and English language. Specific sociodemographic and socioeconomic characteristics, besides the illness-related distress, familiar relationships, exposure characteristics, coping style, and support, were identified as relevant risk/protective factors for PTSD. The review limitations are the small number of studies; studies on different types of diseases; studies with same samples. It is crucial to consider factors affecting caregivers of severely ill adult patients in order to plan effective intervention strategies aimed at reducing the risk of an adverse mental health outcome and at enhancing the psychological endurance of this population.

Posttraumatic Stress Symptoms, Quality of Life, and Stress Burden in Caregivers of Patients With Severe Mental Illness: An Underestimated Health Concern

“…This observation highlights the magnitude of the burden and its devastating sequelae among caregivers ( 3 – 5 ). Carmassi et al ( 6 ) recently published an interesting systemic review article where Posttraumatic stress disorder (PTSD) in caregivers of patients with severe mental illness was studied and different factors in those caregivers were then subcategorized as modifiable or permanent factors. This new perspective provided a potential research orientation that can help in the development of various psychological interventions to address that issue and prevent PTSD among caregivers of patients with severe mental illness ( 6 ).…”

“…In fact, the definition of the traumatizing event that may precipitate PTSD has evolved over the years and now includes a relativity dimension; thus, the event is considered significant as long as it is traumatizing to the patient ( 13 ). Traumatic events are typically linked to injuries, war, and natural disasters but is rarely attributed to the experience of providing long-term care for patients with chronic and/or severe mental illness, even though caregivers are frequently subjected to psychological and sometimes physical threats that can arouse feelings of deep distress and helplessness consistent with PTS ( 6 , 14 ). The imbalance in the relationship between the caregiver and care receiver is aggravated when the latter has cognitive impairment; additionally, the process of caregiving can negatively affect the caregiver's relationships with other family members or partners/spouses ( 5 , 6 ).…”

Post-Traumatic Stress Reactions in Caregivers of Children and Adolescents/Young Adults with Severe Diseases: A Systematic Review of Risk and Protective Factors

“…Severe acute or chronic illnesses represent a stressful burden for patients and their caregivers. Moreover, they may favor the onset of a wide range of psychological problems in carers, such as depression, anxiety, sleep disturbances, and post-traumatic stress disorder (PTSD) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. PTSD is a condition that may occur after traumatic events, life-threatening events, or painful experiences [ 10 , 11 , 12 ].…”

“…Furthermore, PTSD has been positively associated to an increased risk of other psychopathological conditions and substance abuse, leading to a well-being impairment [ 34 , 35 , 36 ]. In this line, increasing evidence suggests that PTSD or PTSS could be associated to the onset of depression, suicidal behavior, anxiety, sleep problems, and other conditions in cares that worse their quality of life [ 1 , 2 , 4 , 7 , 9 ].…”

Disrupted Rhythmicity and Vegetative Functions Relate to PTSD and Gender in Earthquake Survivors

“…Possible gender differences in such symptomatology have been even reported to a lesser extent. Current literature recognizes that women may have a twofold risk for PTSD, with respect to men exposed to the same traumatic event (6)(7)(8)(9). Again, increased evidence suggests the former to report more severe symptoms than the latter, with the only exception of reckless and self-destructive behaviors (10)(11)(12)(13)(14)(15), although a few studies have specifically focused on neurovegetative alterations in PTSD.…”