Positive and negative impacts of schizophrenia on family caregivers: a systematic review and qualitative meta-summary

  • Nao ShiraishiEmail author
  • Jacqueline Reilly



Schizophrenia places a heavy burden on the individual with the disorder, as well as on his or her family; this burden continues over the long course of the disease. This study aimed to provide an overview of the positive and negative impacts of schizophrenia on family caregivers.


From April to June 2017, two investigators conducted a systematic review and meta-summary of studies obtained from five electronic databases and the footnotes and citations of eligible studies. Qualitative studies that explored the experiences of family caregivers of individuals with schizophrenia were included. Study findings published between 1993 and 2017 were extracted and synthesised using narrative and summative approaches.


After the removal of duplicates, independent reviewers screened 864 records. Subsequently, 46 full-text articles were assessed for eligibility and 23 papers were included in the synthesis. Negative impacts identified were traumatic experiences, loss of expectation of life and health, lack of personal and social resources, uncertainty and unpredictability, family disruption, conflict in interpersonal relationships, difficulty in understanding, and stigma and heredity. Meanwhile, the positive impacts identified were family solidarity, admiration, affirmation, affection, compassion, learning knowledge and skills, self-confidence, personal growth, and appreciation.


Analysis of the studies suggested that family members of individuals with schizophrenia face a series of traumatic situations during the course of the illness. Their subsequent experiences can be conceptualised as a continuous circle of caregiving, in which the positive impacts can be centrally positioned within the negative impacts.


Qualitative synthesis Caregiving process Caregiver burden Caregiver benefits Mandala 



We thank Prof. Tatsuo Akechi, chairman of the Department of Psychiatry, Graduate School of Medical Sciences, who provided comments that contributed to the revision of the manuscript draft. No financial support was obtained from any source for this study.

Compliance with ethical standards

Conflict of interest

We declare no competing interests.

Supplementary material

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Supplementary material 1 (DOCX 46 KB)
127_2018_1617_MOESM2_ESM.docx (48 kb)
Supplementary material 2 (DOCX 47 KB)


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Authors and Affiliations

  1. 1.Department of Psychiatry and Cognitive-Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
  2. 2.Department of Public HealthUniversity of GlasgowGlasgowUK

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