流浪者人群中精神分裂症和其他精神病性障碍的流行率：系统评价和荟萃分析。
The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis.
机构信息
Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.
Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
BMC Psychiatry. 2019 Nov 27;19(1):370. doi: 10.1186/s12888-019-2361-7.
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 I 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), I = 99.43%], schizophrenia [10.29% (95%, CI: 6.44, 16.02), I = 98.76%], schizophreniform disorder [2.48% (95% CI: 6.16, 28.11), I = 88.84%] schizoaffective disorder [3.53% (95% CI: 1.33, 9.05), I = 31.63%,] as well as psychotic disorders not otherwise specified [9% (95% CI: 6.92, 11.62), I = 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.
背景
精神分裂症和其他精神病障碍给全球带来了巨大的疾病负担，也是导致无家可归者残疾和过早死亡的主要原因之一。本系统综述和荟萃分析旨在评估无家可归者中精神分裂症和其他精神病障碍的总患病率。
方法
检索了 PubMed、Embase 和 Scopus 以确定相关研究。我们使用固定效应或随机效应荟萃分析，根据预期的异质性，对纳入研究的数据进行汇总。使用了预先设计的搜索策略以及纳入和排除标准。我们还进行了亚组和敏感性分析，并使用 Cochran's Q 和 I 检验来计算异质性。Egger 检验和漏斗图的对称性视觉检查用于评估发表偏倚。
结果
最终分析纳入了 31 项涉及 51925 名无家可归者的研究。荟萃分析显示，精神病的患病率显著更高[21.21%（95%CI：13.73，31.29），I=99.43%]，精神分裂症[10.29%（95%CI：6.44，16.02），I=98.76%]，分裂样障碍[2.48%（95%CI：6.16，28.11），I=88.84%]，分裂情感障碍[3.53%（95%CI：1.33，9.05），I=31.63%]以及未特定的精神病障碍[9%（95%CI：6.92，11.62），I=33.38%]。发展中国家（29.16%）的精神病患病率高于发达国家（18.80%）。同样，发展中国家（22.15%）的精神分裂症患病率也高于发达国家（8.83%）。
结论
本系统综述和荟萃分析显示，精神分裂症和其他精神病障碍在无家可归者中患病率很高，这表明迫切需要研究来帮助制定更好的预防、发现和治疗无家可归者中这些障碍的机制。
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