Developmental Outcomes and Caregiving Burdens Among Children and Adolescents of Parents With Schizophrenia Spectrum Disorders: A Systematic Review

The purpose of this systematic review was to examine the developmental outcomes and caregiving burdens of the children and adolescents that have parents diagnosed with schizophrenia spectrum disorders. Following the Cochrane Handbook and the PRISMA guidelines, five electronic databases (PubMed, EMBASE, Cochrane Library, CINAHL, and PsycINFO) were systematically searched for studies published between January 2015 and December 2024. Eight quantitative studies met the inclusion criteria and were synthesised descriptively. The findings revealed that the children and adolescents of parents with schizophrenia spectrum disorders had a significantly higher risk of adverse outcomes across multiple developmental domains. They showed increased vulnerability to sexually transmitted infections, teenage pregnancies, and chronic diseases. Cognitive impairments, including poor working memory, processing speed, learning, and emotional recognition, were reported. Emotional and behavioural problems such as anxiety, depression, aggression, and low self-esteem were more frequent, while social difficulties included poorer peer relationships, lower academic achievement, and an increased likelihood of out-of-home placement. However, evidence regarding caregiving burdens, such as parentification or role reversals, was scarce, despite the potential relevance to this population. The review also determined that factors such as sex, age, family environment, and socioeconomic disadvantage amplified children and adolescents' vulnerabilities. In conclusion, the children and adolescents of parents with schizophrenia spectrum disorders face multidimensional developmental challenges; however, research on their caregiving burdens remains insufficient. Longitudinal studies across diverse populations are needed to clarify the long-term effects. The development of reliable tools to measure caregiving burdens is warranted. Interventions considering sex, age, and contextual factors, together with integrated family-centred support, are crucial for promoting resilience and reducing risks in these children and adolescents. Trial Registration: PROSPERO database (CRD42025640649).