UNDERSTANDING CAREGIVER PSYCHOLOGICAL DISTRESS THROUGH PATIENT'S LACK OF INSIGHT AND PERCEIVED STIGMA IN PSYCHOTIC DISORDERS: A SYSTEMATIC REVIEW

Abstract

Family caregivers of individuals with psychotic disorders are disproportionately affected by psychological distress, including anxiety, depression, and caregiver burden. A range of clinical and psychosocial factors including patient's lack of insight, perceived stigma, treatment non-adherence, social isolation, and insufficient social support are known to exacerbate this distress. The present systematic review examined the individual and combined contributions of patient's lack of insight and perceived (affiliate) stigma to caregiver psychological distress. A systematic search of Google Scholar, PubMed, and Elsevier databases was conducted for studies published between 2018 and 2026. Fourteen studies meeting the inclusion criteria were identified, encompassing quantitative, qualitative, and mixed-method designs (including correlational, cross-sectional, longitudinal, and meta-synthesis studies). Findings consistently indicated that both patient's lack of insight and caregivers' perceived stigma significantly and interactively contribute to elevated psychological distress among family caregivers of individuals with psychotic disorders. Clinical implications and directions for future research are discussed.