Abstract
Background and Aim: Mental health and quality of life are commonly affected in patients with thalassemia and their caregivers. This review aims to synthesize the available evidence and to assess the prevalence of depression and anxiety in patients with thalassemia and their caregivers. This review also examines the bidirectional relationship between thalassemia and depression and anxiety and its impact on the quality of life of patients and their caregivers.

Methods: Five electronic databases were searched [PsychInfo, PubMed, Medline, Google Scholar, and EMBASE] and also other sources. This search combined different terms of mental health and quality of life of patients with thalassemia and caregivers. The search went up until January 2019

Results: Forty articles are included in this review. The studies showed a high prevalence of mental illnesses, particularly depression and anxiety, among patients with thalassemia and their caregivers. Many factors have been found that impacts the quality of life of patients with thalassemia and their caregivers, including thalassemia, its related-complications, medical treatment and, psychological distress, and comorbid mental illness. Although all the studies that looked at comorbid mental illness and thalassemia recommended adding a psychological treatment, only three studies did investigate this and had shown some benefits.

Conclusion: Thalassemia should be addressed as an illness with biopsychosocial components and should be treated as such. More studies are needed to assess the effectiveness of different psychological interventions for patients with thalassemia and their caregivers. Also, two new psychotherapies are mentioned and discussed as they address the psychological needs of patients and their caregivers.

Key words: Thalassemia, Depression, Anxiety, Therapy, Quality of life, Caregivers