OBJECTIVES: Schizophrenia affects 1% of population globally. In the United States (US), indirect costs, including costs of caregiving, contribute the most to the economic burden of schizophrenia (Kotzeva ,2022). Although indirect cost data are available, a global view and understanding of the economic burden of caregiving is lacking. This review summarizes caregiver burden among schizophrenia patients across countries.

METHODS: Studies reporting hours spent on formal (professional) and informal caregiving (family/friends) for schizophrenia patients, work productivity loss, and costs associated with caregiving were included. The Cochrane library, Medline and EMBASE databases, and bibliographies of published papers were searched from 2000-2022. Data were extracted and synthesized in narrative form. Cost estimates were converted to 2022 US dollars.

RESULTS: Twenty-eight papers were included. Caregivers spent on average 8 hours/week in Asia (Thailand, China, India), 29 hours/week in Europe, and 36 hours/week in the US caring for patients with schizophrenia. Average annual caregiver costs ranged from $1,586 in China to $30,591 in the US. Burden of informal care exceeded that of formal care across all countries, with 4% to 19% of informal caregivers giving up work due to their additional caregiving responsibilities. Costs associated with caregiver’s lost productivity were the main drivers of caregiving costs and varied across countries.

CONCLUSIONS: Average hours spent and costs for schizophrenia caregiving are higher in Western countries (US and Europe) as compared to other countries, which could be attributed to the cultural and societal differences, local economic state, as well as widespread methodological heterogeneity in the studies (e.g., definition of caregiving). Hours of informal care provided may limit caregiver’s productivity and reduces their capacity to earn an income potentially leading to greater economic burden. Providing optimal training and support to caregivers may help alleviate productivity losses leading to significant savings in societal costs among caregivers of schizophrenia patients.