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Meta-Analysis
. 2019 Nov 27;19(1):370.
doi: 10.1186/s12888-019-2361-7.

The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis

Getinet Ayano  1 , Getachew Tesfaw  2 , Shegaye Shumet  2
Affiliations
Meta-Analysis

The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis

Getinet Ayano et al. BMC Psychiatry. .

Abstract

Background: Schizophrenia and other psychotic disorders constitute a huge global burden of disease and they are major contributors to disability as well as premature mortality among homeless people. This systematic review and meta-analysis aimed to estimate the pooled prevalence of schizophrenia and other psychotic disorders among homeless people.

Methods: PubMed, Embase, and Scopus were searched to identify pertinent studies. We used a fixed- or random-effect meta-analysis to pool data from the included studies depending on the anticipated heterogeneity. A predesigned search strategy, as well as inclusion and exclusion criteria, were used. We also performed subgroup and sensitivity analysis and Cochran's Q- and the I2 test was employed to compute heterogeneity. Egger's test and visual inspection of the symmetry in funnel plots were used to assess publication bias.

Results: Thirty-one studies involving 51,925 homeless people were included in the final analysis. The meta-analysis showed a remarkably higher prevalence of psychosis [21.21% (95% CI:13.73, 31.29), I2 = 99.43%], schizophrenia [10.29% (95%, CI: 6.44, 16.02), I2 = 98.76%], schizophreniform disorder [2.48% (95% CI: 6.16, 28.11), I2 = 88.84%] schizoaffective disorder [3.53% (95% CI: 1.33, 9.05), I2 = 31.63%,] as well as psychotic disorders not otherwise specified [9% (95% CI: 6.92, 11.62), I2 = 33.38%] among homeless people. The prevalence estimate of psychosis was higher in developing (29.16%) as compared to developed (18.80%) countries. Similarly, the prevalence of schizophrenia was highest in developing (22.15%) than developed (8.83%) countries.

Conclusion: This systematic review and meta-analysis revealed that schizophrenia and other psychotic disorders are highly prevalent among homeless people, indicating an urgent need for studies to help develop better mechanisms of prevention, detection as well as treatment of those disorders among homeless people.

Keywords: Homeless; Meta-analysis; Psychotic disorder; Schizophrenia; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of review search. This figure shows the process of searching of pertinent studies form the three databases including identification, selection, eligibility and inclusion of the studies depending on the predefined criteria
Fig. 2
Fig. 2
Forest plot of the prevalence of psychosis among homeless people. The figure shows the results of the meta-analysis of the studies on psychosis on homeless people suing random effect model
Fig. 3
Fig. 3
forest plot of the prevalence of schizophrenia among homeless people. This figure illustrates the results of the meta-analysis of the studies on schizophrenia on homeless people suing random effect model
Fig. 4
Fig. 4
Forest plot of the prevalence of schizophreniform disorders among homeless people. The figure shows the results of the meta-analysis of the studies on schizophreniform disorders on homeless
Fig. 5
Fig. 5
forest plot of the prevalence of schizoaffective disorders among homeless people. The figure shows the results of the meta-analysis of the studies on schizoaffective disorders on homeless
Fig. 6
Fig. 6
Forest plot of the prevalence of psychotic disorders NOS among homeless people. The figure shows the results of the meta-analysis of the studies on psychotic disorders not otherwise specified (NOS) on homeless
Fig. 7
Fig. 7
Publication bias for schizophrenia among homeless people
Fig. 8
Fig. 8
Publication bias for psychosis among homeless people
See this image and copyright information in PMC

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