Coping, Subjective Burden and Mental Health in Family Carers of Dependent Children and Adolescents: A Systematic Review With Meta-Analysis.

INTRODUCTION

Caring for dependent children and adolescents places a substantial emotional and psychological burden on families. Coping strategies may influence the mental health of family carers.

AIM: To systematically review how coping strategies relate to subjective burden, anxiety, and depressive symptoms in family carers of dependent children and adolescents.

METHOD: Systematic review and random-effects meta-analysis were performed, searching PubMed, PsycINFO, CINAHL, and LILACS (up to June 2025). Observational studies examining the association between coping strategies and subjective burden, anxiety, or depression in family members caring for dependent children aged under 18 were included. Study quality was assessed via sampling method, instrument reliability, and confounder control.

RESULTS

Thirty-eight studies (42 samples; 4548 participants) were included. Dysfunctional coping was consistently associated with more depressive symptoms, anxiety, and subjective burden. In contrast, functional coping was related to fewer depressive symptoms and subjective burden. Emotion-focused coping and its individual strategies were generally associated with less psychological distress. Problem-focused coping showed mixed results.

DISCUSSION: Dysfunctional coping appears to represent a risk to carers' mental health, whereas functional coping-particularly emotion-focused strategies-might be protective. However, all studies were cross-sectional.

IMPLICATIONS FOR PRACTICE: Assessing and encouraging adaptive strategies, especially those focused on emotion coping, could improve carers' mental health.

TRIAL REGISTRATION: International Prospective Register of Systematic Reviews: PROSPERO: CRD42024533044.