Burden Beyond the Bedside: A Global Synthesis of Depression in Informal Cancer Caregivers: An Umbrella Review.

Abstract

The aim of this umbrella review is to synthesize pooled prevalence of existing evidence on depressive morbidity among informal cancer caregivers. This umbrella review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD420251032522). A comprehensive search of major databases was performed to identify relevant studies. Predefined inclusion and exclusion criteria were applied. The corrected covered area (CCA) was calculated to assess overlap, and the methodological quality of included reviews was evaluated using the AMSTAR 2 tool. This umbrella review included four systematic reviews and meta-analyses, comprising a total of 160 primary studies with 40,605 participants worldwide. The pooled global prevalence of depression among informal caregivers of cancer patients was 38% (95% confidence intervals, 95% CI: 28%-48%). However, prevalence estimates varied widely, ranging from 4 to 55%, likely due to differences in the depression assessment tools used across studies. In conclusion, this review reveals a high prevalence of depression among informal caregivers of cancer patients a burden comparable to or exceeding that observed in other chronic illnesses and global crises such as the COVID-19 pandemic. Integrating routine mental health screening using validated tools such as the CES-D or PHQ-9 into oncology care is essential. Structured interventions including counseling, psych-education, and respite care should be embedded within care pathways. Future research should prioritize standardized assessment tools and caregiver-focused strategies to enhance comparability and guide best practices. Policymakers must invest in caregiver mental health to ensure sustainable and compassionate cancer care systems.