Mapping global evidence of caregiver experiences in bipolar disorder in low and middle-income countries: A scoping review

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.