Scoping Review of Mental Distress among Caregivers of Children and Adolescents with Behavioral Problems in Low and Middle Income Countries

Background Caregivers play a crucial role in the emotional, social, and behavioral development of children and adolescents. When children exhibit behavioral problems, caregivers often experience considerable burden, reflected in internal perceptions of emotional exhaustion, worry, and psychological strain. This burden is associated with heightened mental distress among caregivers, manifesting as symptoms of depression and anxiety. Individual caregiver factors (e.g., poor mental health, ineffective coping strategies) and contextual factors (e.g., low family income, limited social support, inadequate access to mental health care, stigma) can exacerbate this distress. Despite growing evidence, there is still a scarcity of scoping reviews that examine the burden and associated factors in low- and middle-income countries (LMICs). Objective This scoping review aims to estimate the burden and systematically map the individual and contextual factors associated with mental distress among caregivers of children and adolescents with behavioral problems in low-and middle-income countries (LMICs). Methods Four databases (PubMed, Embase, PsycINFO, and MEDLINE) and google scholar will be searched from their inception to 28 September 2025. Studies will be included if they focused on primary caregivers aged 18 years or older of children and adolescents with behavioral problems, including externalizing behaviors (e.g., aggression, disobedience) and internalizing behaviors (e.g., anxiety, depression), report primary caregivers’ mental distress using validated measures, and be published in English. The review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Critical appraisal will be done using the Newcastle-Ottawa Scale.