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A Systematic Review and Meta-Analysis of the Prevalence of Post-Traumatic Stress Disorder among Homeless People

Psychiatric Quarterly volume 91, pages 949–963 (2020)Cite this article

Abstract

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 I2 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.

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Acknowledgments

We are delighted to acknowledge all the authors from the included studies.

Author information

Authors and Affiliations

  1. Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

    Getinet Ayano & Melat Solomon

  2. School of public health, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia

    Getinet Ayano

  3. Department of Psychiatry, Aksum University, Aksum, Ethiopia

    Light Tsegay

  4. Department of Psychiatry, Dilla University, Dilla, Ethiopia

    Kalkidan Yohannes

  5. Department of Psychiatry, Paulo’s millennium medical college, Addis Ababa, Ethiopia

    Mebratu Abraha

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  1. Getinet Ayano
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  2. Melat Solomon
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  3. Light Tsegay
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  4. Kalkidan Yohannes
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  5. Mebratu Abraha
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Contributions

The author (GA) conceptualized the study, conducted analyses, write-up and approval of the final manuscript. MA was performed the search, data extraction, quality assessment, write the discussion, draft and approved the final manuscript. LT and KY were participated in discussion and consensus and approved the final manuscript.

Corresponding author

Correspondence to Getinet Ayano.

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The authors declare that there are no competing interests.

List of Abbreviations

DSM Diagnostic and Statistical Manual of Mental Disorders

ICD International Classification of Disease

MINI Mini-International Neuropsychiatric Interview

NOS Newcastle-Ottawa Scale

PC-PCL The Primary Care PTSD Checklist

PTSD Post-Traumatic Stress Disorder

SCID Structured Clinical Interview for DSM

TSQ Trauma Screening Questionnaire

USA United States of America

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Ayano, G., Solomon, M., Tsegay, L. et al. A Systematic Review and Meta-Analysis of the Prevalence of Post-Traumatic Stress Disorder among Homeless People. Psychiatr Q 91, 949–963 (2020). https://doi.org/10.1007/s11126-020-09746-1

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