Considering the family environment of the person on the autism spectrum is essential to ensure that the child will receive adequate support as well as mental health care for parents and siblings. Parents of children on the autism spectrum experience more significant distress than parents of neurotypical children (NC). The greater the needs the family reports, the less effective their coping strategies are, and the greater the likelihood of stress, depression, and anxiety (Marques and Dixe, 2011).

Siblings of individuals on the autism spectrum seem more affected by depressive symptoms than NC. These symptoms intensify as the level of support demanded by children on the autism spectrum becomes more remarkable, but are reduced with a family support network and a network of friends (Lovell and Wetherell, 2016).

Societal stigma could also contribute to psychopathological symptoms of relatives of people on the autism spectrum. Firstly, because of society's negative correlations to autism (Botha et al., 2022). Secondly, the stereotyping and exclusion of children on the autism spectrum (Kinnear et al., 2016).

Specifically aimed at stress levels and possible predisposing factors for psychopathological symptoms in relatives of individuals on the autism spectrum, to the best of our knowledge, this is the first systematic review with meta-analysis to investigate the frequency of psychopathological symptoms in parents and siblings of people on the autism spectrum.