Prevalence of anxiety, depression, and posttraumatic stress disorder in caregivers of children with epilepsy: A meta-analysis

Objectives

This systematic review with meta-analysis (PROSPERO: CRD42022377532) was performed to comprehensively assess the prevalence of anxiety, depression, and posttraumatic stress disorder (PTSD) in caregivers of children with epilepsy.

Methods

A search was performed on June 2024, in 4 databases (PubMed, Embase, Web of Science, and PsycInfo) for original research reporting on caregivers of children with epilepsy, with no language restrictions. Two reviewers independently screened and extracted data. The methodological quality was assessed using the Healthcare Research and Quality of America (AHRQ) standardized appraisal tool. Random-effects models were used to calculate the pooled prevalence of anxiety, depression, and PTSD. The subgroup analysis was further conducted to identify possible sources of heterogeneity. All studies were reviewed by PRISMA guidelines.

Results

A total of 2,588 records were screened and 38 studies with 6,593 participants across 18 countries were included for analysis: 25 studies provided prevalence estimates for anxiety, 33 for depression, and 5 for PTSD. Eleven studies were rated as high quality according to the AHRQ scale, 24 as moderate quality, and 3 as low quality. The pooled prevalence of anxiety was 34 % (95 %CI 0.28–0.41) with considerable heterogeneity (I² = 96.18 %), 31 % for depression (95 %CI 0.24–0.37) with substantial heterogeneity (I² = 97.60 %), and 21 % for PTSD (95 %CI 0.17–0.26) with moderate heterogeneity (I² = 55.02 %). Significant heterogeneity was observed, particularly concerning anxiety and depression, which could be attributed to variations in screening methods. However, no statistical differences were found between subgroups based on gender, region, year of publication, type of seizure, economic development level of countries. In the gender subgroup analysis for PTSD, females had a higher prevalence (24 %) than males (6 %). In the sensitive analysis of PTSD, the prevalence was 23 % with low heterogeneity (I² = 22.94 %) by excluding one study.

Conclusion

We systematically analyzed the prevalence of anxiety, depression, and PTSD in caregivers of children with epilepsy. Our findings highlight the high mental health burden among caregivers, with prevalence rates notably higher than those in the general population. These results emphasize the urgent need for early identification, interventions, and comprehensive support to improve the well-being and quality of life of these caregivers.