{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:29:47Z","timestamp":1786645787548,"version":"build-2736575974"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006016","name":"College of Medicine, King Saud University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006016","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Caregivers of patients with Severe Persistent Mental Illness (SPMI) face tremendous challenges. They often experience elevated levels of burden, depression, and anxiety. These factors negatively impact their quality of life (QoL). However, few studies have examined caregiver burden and its psychological effects in Saudi Arabia. This study aims to assess caregiver burden in relation to socio-demographic characteristics and its correlation with depression, anxiety, and QoL. The study tool consisted of validated\u00a0questionnaire, including the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), abridged Arabic version of the Zarit Burden Interview (ZBI), and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF). A cross-sectional convenience sample of 120 participants was recruited from the Psychiatry Outpatient Clinics at King Saud University Medical City in Riyadh, Saudi Arabia. Our results showed a significant positive correlation between caregiver burden and depression and anxiety scores (p\u2009&lt;\u20090.001). Moreover, significantly higher burden levels were found among female caregivers and those residing with patients, p\u2009=\u20090.04 and p\u2009=\u20090.002, respectively. Additionally, the severity of mental illness was also associated with an increased burden level (p\u2009=\u20090.001). Notably, spouses and children reported significantly higher burden levels (p\u2009=\u20090.036). In multivariable analyses, caregiver anxiety and perceived severity of the patient\u2019s mental illness were independently associated with higher caregiver burden, while depressive and anxiety symptoms were independently associated with poorer quality of life.Furthermore, a significant negative correlation was found between caregiver burden and the physical and psychological QoL domains (p\u2009&lt;\u20090.001 and p\u2009=\u20090.013, respectively). Collectively, our findings highlight the mental health challenges faced by caregivers of individuals with SPMI in Saudi Arabia, which negatively impact their QoL. Consequently, these findings substantiate the urgent need for targeted support interventions, particularly those addressing caregiver anxiety, depression, and the challenges associated with severe mental illness, especially for caregivers who live with or care for individuals with SPMI.<\/jats:p>","DOI":"10.1371\/journal.pone.0355872","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:37:15Z","timestamp":1786642635000},"page":"e0355872","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Caregiver burden and its association with depression, anxiety, and quality of life among caregivers of individuals with severe persistent mental illness in Saudi Arabia: A cross-sectional 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