OBJECTIVES: The impact of caregiving on quality of life is well-established, with a growing body of research demonstrating psychiatric manifestations including PTSD. While data exist on the economic burden of PTSD, the economic impact of caregiver-related PTSD is not well-characterized. Our objective was to review the literature and develop a framework to estimate the economic burden of caregiver PTSD.

METHODS: We conducted a targeted literature review in PubMed, using search terms related to PTSD, caregiving, and economic burden. A pearl-growing approach identified additional relevant articles from reference lists of key publications. No language or date limits were applied.

RESULTS: No publications on economic burden of caregiver PTSD were found. We identified 28 publications reporting PTSD prevalence in caregivers of adults and children with various physical and psychiatric illnesses. Prevalence rates ranged from 3%–82.9%, with most studies reporting a range from 12%–30%, varying with patient age, diagnosis/clinical situation, and criteria used to define PTSD. This range mirrors the 11%–30% reported by the US Veterans Administration for combat veterans. Several publications characterize the economic burden of PTSD; one systematic review estimated US per-person direct costs of $512–$19,435 and indirect costs of $5,021. We propose a methodological framework by which to characterize the economic burden of caregiver PTSD for different clinical scenarios: 1) Identify the prevalence of the clinical situation; 2) Identify the prevalence of caregiver PTSD in the situation; 3) Employ expert input to characterize the severity of caregiver PTSD in the situation; 4) Use severity-matched PTSD costs in the relevant country/region to calculate costs of caregiver PTSD.

CONCLUSIONS: PTSD, which is prevalent among caregivers, impacts well-being and incurs substantial direct and indirect costs. Our framework allows estimation of the economic impact of caregiver PTSD in different clinical situations and regions, which could help justify the implementation of caregiver screening and treatment.