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Meta-Analysis
. 2020 Jun 9;20(1):731.
doi: 10.1186/s12889-020-08819-x.

A systematic review and meta-analysis of the prevalence of bipolar disorder among homeless people

Getinet Ayano  1   2 , Shegaye Shumet  3 , Getachew Tesfaw  3 , Light Tsegay  4
Affiliations
Meta-Analysis

A systematic review and meta-analysis of the prevalence of bipolar disorder among homeless people

Getinet Ayano et al. BMC Public Health. .

Abstract

Background: Bipolar disorder (BD) is a common severe mental disorder among homeless people and is associated with an increased risk of disability and mortality from suicide, medical causes (including HIV/AIDS, hepatitis infection, hypertension, and tuberculosis), as well as substance use disorders. However, a systematic synthesis of the existing evidence on the subject is lacking. To fill this gap in the literature, this study aimed to carry out systematic review and meta-analysis to determine the consolidated prevalence of BD among homeless people.

Methods: In this systematic review and meta-analysis, we searched Embase, PubMed, and Scopus to identify pertinent studies that reported the prevalence of BD among homeless people in March 2019. Random effect meta-analysis was employed to pool data from the eligible studies. Subgroup and sensitivity analysis was conducted and Cochran's Q- and the I2 test were utilized to quantify heterogeneity. Publication bias was assessed by using Egger's test and visual inspection of the symmetry in funnel plots.

Results: Of 3236 studies identified, 10 studies with 4300 homeless individuals were included in the final analysis. Among the 10 studies, five studies used the Diagnostic Statistical Manual of Mental disorders (DSM), three studies used Mini-International Neuropsychiatric Interview (MINI), one study used Schedule for Clinical Assessment of Neuropsychiatry (SCAN), and one study used Composite International Neuropsychiatric Interview (CIDI) to assess BD among homeless individuals. Based on the results of the random effect model, the prevalence of BD among homeless people was 11.4% (95% CI; 7.5-16.9). The prevalence of BD was 10.0% (95% CI; 3.1-27.9) in Europe and it was 13.2% (95% CI; 8.9-19.3) in other countries. Moreover, the prevalence of BD was 11.5% (95% CI; 5.5-22.3) for studies that used DSM to assess BD and it was 11.0% (95% CI; 6.1-19.2) for studies that used other instruments (MINI, SCAN, and CIDI).

Conclusion: Our meta-analysis demonstrated that BD is highly prevalent among homeless individuals, underlying the importance of early screening and targeted interventions for BD among homeless individuals.

Keywords: Bipolar disorder; Homeless; Meta-analysis; Prevalence; Systematic review.

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Conflict of interest statement

The authors declare that there are no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of review search. This figure illustrates the process of searching for relevant studies from the three reputable 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 bipolar disorder among homeless people. The figure shows the results of the meta-analysis of the studies on bipolar disorder among homeless people using random-effect model
Fig. 3
Fig. 3
Publication bias for bipolar disorders among homeless people. Funnel plot of the risk of publication bias for the prevalence of BD among the homeless individuals
See this image and copyright information in PMC

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