Muñoz-Cruz, Juan Carlos; López-Martínez, Catalina; Orgeta, Vasiliki; Del-Pino-Casado, Rafael; (2023) Coping and depressive symptoms in family carers of dependent adults aged 18 and over: A systematic review and meta-analysis. Stress & Health 10.1002/smi.3225. (In press).

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Abstract

Being a family carer is associated with increased risk of experiencing depressive symptoms. Despite many decades of research investigating the association between coping strategies and depressive symptoms in carers results across studies remain contradictory. The objective of this study was to systematically review evidence on the association between depressive symptoms and coping strategies in carers of dependent people aged 18 and over and investigate potential sources of heterogeneity of findings. The study design was a systematic review and meta-analysis. We searched Pubmed, CINAHL, PsycINFO and LILACS up to April 2021. We performed meta-analyses following the PRISMA statement and several subgroup analyses to investigate whether cause of caring dependency, study design, and controlling for several biases influenced results. Fifty-nine studies met our inclusion criteria. We found a robust and statistically significant association between greater use of dysfunctional coping and higher depressive symptoms. Greater use of emotion-focused coping was associated with fewer depressive symptoms only in studies controlling for confounding bias. Use of problem-focused coping was related to fewer depressive symptoms in carers of frail older people. The combined use of both problem-focused and emotion-focused coping was associated with lower symptoms of depression. Our review concludes that the broad domain of dysfunctional coping is consistently associated with higher levels of depressive symptoms in carers. After controlling for confounders, emotion-focused coping and several of its individual strategies were consistently associated with fewer depressive symptoms. Whilst problem-focused coping and some of its individual strategies are also associated with lower depressive symptoms, these strategies may not be as helpful in all caregiving groups.Clinical Impact Statement: fcBoth broad dimensions of coping and individual coping strategies are important correlates of depressive symptoms in family carers, and should be utilized in informing and improving the effectiveness of future caregiving interventions.

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