Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.
School of public health, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia.
Psychiatr Q. 2020 Dec;91(4):949-963. doi: 10.1007/s11126-020-09746-1.
Post-traumatic stress disorder (PTSD) is common among homeless people and is associated with an increased risk of mortality from suicide, medical causes, and drug-related problems. However, there are no previous systematic review and meta-analysis studies that reported the consolidated magnitude of PTSD among homeless people. A literature search was conducted on PubMed, Embase, and Scopus to discover pertinent studies that determined the prevalence of PTSD among the homeless. Articles were evaluated by titles, abstracts, and full-text. Comprehensive meta-analysis software was used to conduct the meta-analysis. Subgroup and sensitivity analysis were performed and Cochran's Q- and the I test were used to assess heterogeneity. The evidence of publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots. From the total, 19 studies with 20,364 participants across seven countries were included in the final analysis. Our meta-analysis revealed that the pooled prevalence of PTSD among homeless people was 27.38% (95% CI; 21.95-33.57). In our subgroup analysis, we found that the prevalence of PTSD was considerably high as measured by the screening instrument (35.93%) than the diagnostic instrument (23.57% %). The prevalence of PTSD among homeless showed a significant variation by the location of the studies, the instruments used to measure PTSD as well as the quality of the included studies. This review showed that the pooled prevalence estimate of PTSD among homeless peoples was remarkably high (27.38%). Early screening and treatment of PTSD among homeless peoples are warranted to alleviate suffering.
创伤后应激障碍（PTSD）在 homeless people 中很常见，并且与自杀、医疗原因和与药物相关的问题导致的死亡率增加有关。然而，以前没有系统的综述和荟萃分析研究报告过 homeless people 中 PTSD 的综合发生率。我们在 PubMed、Embase 和 Scopus 上进行了文献检索，以发现确定 homeless people 中 PTSD 患病率的相关研究。通过标题、摘要和全文评估文章。使用 Comprehensive Meta-Analysis 软件进行荟萃分析。进行了亚组和敏感性分析，并使用 Cochran's Q 和 I 检验评估异质性。使用 Egger's 检验和漏斗图的对称性视觉检查评估发表偏倚的证据。总共纳入了来自七个国家的 19 项研究，共 20364 名参与者。我们的荟萃分析表明， homeless people 中 PTSD 的总患病率为 27.38%（95%CI；21.95-33.57）。在我们的亚组分析中，我们发现使用筛查工具（35.93%）测量的 PTSD 患病率明显高于使用诊断工具（23.57%）。 homeless people 中 PTSD 的患病率因研究地点、用于测量 PTSD 的工具以及纳入研究的质量而有显著差异。这项综述表明， homeless people 中 PTSD 的总患病率估计非常高（27.38%）。有必要对 homeless people 进行 PTSD 的早期筛查和治疗，以减轻痛苦。
