The Prevalence of Mental Disorders among the Homeless in Western Countries: Systematic Review and Meta-Regression Analysis
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{"title"=>"The prevalence of mental disorders among the homeless in Western countries: Systematic review and meta-regression analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Seena", "last_name"=>"Fazel", "scopus_author_id"=>"7003589504"}, {"first_name"=>"Vivek", "last_name"=>"Khosla", "scopus_author_id"=>"25957653600"}, {"first_name"=>"Helen", "last_name"=>"Doll", "scopus_author_id"=>"7005767637"}, {"first_name"=>"John", "last_name"=>"Geddes", "scopus_author_id"=>"56883972800"}], "year"=>2008, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "pui"=>"354059882", "pmid"=>"19053169", "isbn"=>"1549-1277", "doi"=>"10.1371/journal.pmed.0050225", "sgr"=>"58149462683", "scopus"=>"2-s2.0-58149462683"}, "id"=>"79ef66bf-e6cd-32f2-9c52-1a3048a94abb", "abstract"=>"BACKGROUND: There are well over a million homeless people in Western Europe and North America, but reliable estimates of the prevalence of major mental disorders among this population are lacking. We undertook a systematic review of surveys of such disorders in homeless people. METHODS AND FINDINGS: We searched for surveys of the prevalence of psychotic illness, major depression, alcohol and drug dependence, and personality disorder that were based on interviews of samples of unselected homeless people. We searched bibliographic indexes, scanned reference lists, and corresponded with authors. We explored potential sources of any observed heterogeneity in the estimates by meta-regression analysis, including geographical region, sample size, and diagnostic method. Twenty-nine eligible surveys provided estimates obtained from 5,684 homeless individuals from seven countries. Substantial heterogeneity was observed in prevalence estimates for mental disorders among the studies (all Cochran's chi(2) significant at p < 0.001 and all I(2) > 85%). The most common mental disorders were alcohol dependence, which ranged from 8.1% to 58.5%, and drug dependence, which ranged from 4.5% to 54.2%. For psychotic illness, the prevalence ranged from 2.8% to 42.3%, with similar findings for major depression. The prevalence of alcohol dependence was found to have increased over recent decades. CONCLUSIONS: Homeless people in Western countries are substantially more likely to have alcohol and drug dependence than the age-matched general population in those countries, and the prevalences of psychotic illnesses and personality disorders are higher. Models of psychiatric and social care that can best meet these mental health needs requires further investigation.", "link"=>"http://www.mendeley.com/research/prevalence-mental-disorders-among-homeless-western-countries-systematic-review-metaregression-analys-8", "reader_count"=>192, "reader_count_by_academic_status"=>{"Unspecified"=>7, "Professor > Associate Professor"=>7, "Student > Doctoral Student"=>15, "Researcher"=>39, "Student > Ph. D. Student"=>27, "Student > Postgraduate"=>16, "Student > Master"=>43, "Other"=>7, "Student > Bachelor"=>23, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>6}, "reader_count_by_user_role"=>{"Unspecified"=>7, "Professor > Associate Professor"=>7, "Student > Doctoral Student"=>15, "Researcher"=>39, "Student > Ph. D. Student"=>27, "Student > Postgraduate"=>16, "Student > Master"=>43, "Other"=>7, "Student > Bachelor"=>23, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>6}, "reader_count_by_subject_area"=>{"Unspecified"=>14, "Agricultural and Biological Sciences"=>4, "Arts and Humanities"=>4, "Chemistry"=>1, "Earth and Planetary Sciences"=>1, "Economics, Econometrics and Finance"=>3, "Engineering"=>1, "Environmental Science"=>2, "Nursing and Health Professions"=>3, "Mathematics"=>2, "Medicine and Dentistry"=>70, "Neuroscience"=>5, "Physics and Astronomy"=>1, "Psychology"=>46, "Social Sciences"=>35}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>70}, "Social Sciences"=>{"Social Sciences"=>35}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>46}, "Mathematics"=>{"Mathematics"=>2}, "Unspecified"=>{"Unspecified"=>14}, "Environmental Science"=>{"Environmental Science"=>2}, "Arts and Humanities"=>{"Arts and Humanities"=>4}, "Engineering"=>{"Engineering"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Neuroscience"=>{"Neuroscience"=>5}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>3}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>4}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}}, "reader_count_by_country"=>{"Canada"=>1, "United States"=>3, "Denmark"=>1, "Brazil"=>1, "United Kingdom"=>3, "Malaysia"=>1, "Spain"=>1, "India"=>1}, "group_count"=>15}

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  • {"files"=>["https://ndownloader.figshare.com/files/914596"], "description"=>"<p>Prevalence of Psychosis in Homeless Persons by Country Group</p>", "links"=>[], "tags"=>["psychosis", "persons"], "article_id"=>585056, "categories"=>["Mental Health", "Biotechnology"], "users"=>["Seena Fazel", "Vivek Khosla", "Helen Doll", "John Geddes"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.0050225.g002", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_of_Psychosis_in_Homeless_Persons_by_Country_Group_/585056", "title"=>"Prevalence of Psychosis in Homeless Persons by Country Group", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-12-02 01:24:16"}
  • {"files"=>["https://ndownloader.figshare.com/files/914704"], "description"=>"<p>Prevalence of Psychosis in Homeless Persons by Participation Rate</p>", "links"=>[], "tags"=>["psychosis", "persons"], "article_id"=>585165, "categories"=>["Mental Health", "Biotechnology"], "users"=>["Seena Fazel", "Vivek Khosla", "Helen Doll", "John Geddes"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.0050225.g003", "stats"=>{"downloads"=>6, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_of_Psychosis_in_Homeless_Persons_by_Participation_Rate_/585165", "title"=>"Prevalence of Psychosis in Homeless Persons by Participation Rate", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-12-02 01:26:05"}
  • {"files"=>["https://ndownloader.figshare.com/files/475295"], "description"=>"<div><h3>Background</h3><p>There are well over a million homeless people in Western Europe and North America, but reliable estimates of the prevalence of major mental disorders among this population are lacking. We undertook a systematic review of surveys of such disorders in homeless people.</p> <h3>Methods and Findings</h3><p>We searched for surveys of the prevalence of psychotic illness, major depression, alcohol and drug dependence, and personality disorder that were based on interviews of samples of unselected homeless people. We searched bibliographic indexes, scanned reference lists, and corresponded with authors. We explored potential sources of any observed heterogeneity in the estimates by meta-regression analysis, including geographical region, sample size, and diagnostic method. Twenty-nine eligible surveys provided estimates obtained from 5,684 homeless individuals from seven countries. Substantial heterogeneity was observed in prevalence estimates for mental disorders among the studies (all Cochran's χ<sup>2</sup> significant at <em>p</em> < 0.001 and all <em>I</em><sup>2</sup> > 85%). The most common mental disorders were alcohol dependence, which ranged from 8.1% to 58.5%, and drug dependence, which ranged from 4.5% to 54.2%. For psychotic illness, the prevalence ranged from 2.8% to 42.3%, with similar findings for major depression. The prevalence of alcohol dependence was found to have increased over recent decades.</p> <h3>Conclusions</h3><p>Homeless people in Western countries are substantially more likely to have alcohol and drug dependence than the age-matched general population in those countries, and the prevalences of psychotic illnesses and personality disorders are higher. Models of psychiatric and social care that can best meet these mental health needs requires further investigation.</p> </div>", "links"=>[], "tags"=>["prevalence", "disorders", "systematic", "meta-regression"], "article_id"=>153627, "categories"=>["Mental Health", "Biotechnology"], "users"=>["Seena Fazel", "Vivek Khosla", "Helen Doll", "John Geddes"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.0050225", "stats"=>{"downloads"=>13, "page_views"=>46, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/The_Prevalence_of_Mental_Disorders_among_the_Homeless_in_Western_Countries_Systematic_Review_and_Meta_Regression_Analysis/153627", "title"=>"The Prevalence of Mental Disorders among the Homeless in Western Countries: Systematic Review and Meta-Regression Analysis", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2008-12-02 01:00:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/914854"], "description"=>"<div><p>(A) Studies are ordered by increasing study weight in a fixed effects model without calculation of an overall estimate.</p>\n <p>(B) Studies are ordered by increasing study weight and show the overall estimate calculated from random effects meta-analysis.</p></div>", "links"=>[], "tags"=>["dependence"], "article_id"=>585314, "categories"=>["Mental Health", "Biotechnology"], "users"=>["Seena Fazel", "Vivek Khosla", "Helen Doll", "John Geddes"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.0050225.g004", "stats"=>{"downloads"=>2, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_of_Major_Depression_Personality_Disorder_Alcohol_Dependence_and_Drug_Dependence_in_Homeless_People_/585314", "title"=>"Prevalence of Major Depression, Personality Disorder, Alcohol Dependence, and Drug Dependence in Homeless People", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-12-02 01:28:34"}
  • {"files"=>["https://ndownloader.figshare.com/files/914507"], "description"=>"<div><p>(A) Studies are ordered by increasing study weight in a fixed effects model without calculation of an overall estimate.</p>\n <p>(B) Studies are ordered by increasing study weight and show the overall estimate calculated from random effects meta-analysis.</p></div>", "links"=>[], "tags"=>["psychosis"], "article_id"=>584965, "categories"=>["Mental Health", "Biotechnology"], "users"=>["Seena Fazel", "Vivek Khosla", "Helen Doll", "John Geddes"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.0050225.g001", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_of_Psychosis_in_Homeless_Persons_/584965", "title"=>"Prevalence of Psychosis in Homeless Persons", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-12-02 01:22:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/914966"], "description"=>"<p>Prevalence of Alcohol Dependence in Homeless Persons by Decade</p>", "links"=>[], "tags"=>["dependence", "persons"], "article_id"=>585426, "categories"=>["Mental Health", "Biotechnology"], "users"=>["Seena Fazel", "Vivek Khosla", "Helen Doll", "John Geddes"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.0050225.g005", "stats"=>{"downloads"=>4, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_of_Alcohol_Dependence_in_Homeless_Persons_by_Decade_/585426", "title"=>"Prevalence of Alcohol Dependence in Homeless Persons by Decade", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2008-12-02 01:30:26"}

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