ImportanceSeveral factors may place people with mental health disorders, including substance use disorders, at increased risk of experiencing homelessness and experiencing homelessness may also increase the risk of developing mental health disorders. Meta-analyses examining the prevalence of mental health disorders among people experiencing homelessness globally are lacking.ObjectiveTo determine the current and lifetime prevalence of mental health disorders among people experiencing homelessness and identify associated factors.Data SourcesA systematic search of electronic databases (PubMed, MEDLINE, PsycInfo, Embase, Cochrane, CINAHL, and AMED) was conducted from inception to May 1, 2021.Study SelectionStudies investigating the prevalence of mental health disorders among people experiencing homelessness aged 18 years and older were included.Data Extraction and SynthesisData extraction was completed using standardized forms in Covidence. All extracted data were reviewed for accuracy by consensus between 2 independent reviewers. Random-effects meta-analysis was used to estimate the prevalence (with 95% CIs) of mental health disorders in people experiencing homelessness. Subgroup analyses were performed by sex, study year, age group, region, risk of bias, and measurement method. Meta-regression was conducted to examine the association between mental health disorders and age, risk of bias, and study year.Main Outcomes and MeasuresCurrent and lifetime prevalence of mental health disorders among people experiencing homelessness.ResultsA total of 7729 citations were retrieved, with 291 undergoing full-text review and 85 included in the final review (N = 48 414 participants, 11 154 [23%] female and 37 260 [77%] male). The current prevalence of mental health disorders among people experiencing homelessness was 67% (95% CI, 55-77), and the lifetime prevalence was 77% (95% CI, 61-88). Male individuals exhibited a significantly higher lifetime prevalence of mental health disorders (86%; 95% CI, 74-92) compared to female individuals (69%; 95% CI, 48-84). The prevalence of several specific disorders were estimated, including any substance use disorder (44%), antisocial personality disorder (26%), major depression (19%), schizophrenia (7%), and bipolar disorder (8%).Conclusions and RelevanceThe findings demonstrate that most people experiencing homelessness have mental health disorders, with higher prevalences than those observed in general community samples. Specific interventions are needed to support the mental health needs of this population, including close coordination of mental health, social, and housing services and policies to support people experiencing homelessness with mental disorders.

中文翻译：

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无家可归者心理健康障碍的患病率

重要性 有几个因素可能会增加患有精神健康障碍（包括物质使用障碍）的人无家可归的风险，而无家可归也可能会增加患精神健康障碍的风险。缺乏对全球无家可归者心理健康障碍患病率进行荟萃分析的研究。目的确定无家可归者当前和终生心理健康障碍的患病率，并确定相关因素。数据来源系统搜索电子数据库（PubMed、MEDLINE、 PsycInfo、Embase、Cochrane、CINAHL 和 AMED）从开始到 2021 年 5 月 1 日进行。研究选择包括调查 18 岁及以上无家可归者心理健康障碍患病率的研究。数据提取和合成数据提取是使用以下工具完成的Covidence 中的标准化表格。所有提取的数据均经过 2 位独立评审员的一致同意，以确保其准确性。随机效应荟萃分析用于估计无家可归者中精神健康障碍的患病率（95% CI）。按性别、研究年份、年龄组、地区、偏倚风险和测量方法进行亚组分析。进行荟萃回归来检查精神健康障碍与年龄、偏倚风险和研究年份之间的关联。主要结果和措施无家可归者中精神健康障碍的当前和终生患病率。结果总共检索到 7729 条引用，其中 291 条被引用。正在进行全文审查，其中 85 人纳入最终审查（N = 48 414 名参与者，11 154 [23%] 女性和 37 260 [77%] 男性）。目前无家可归者中精神健康障碍的患病率为 67% (95% CI, 55-77)，终生患病率为 77% (95% CI, 61-88)。与女性个体（69%；95% CI，48-84）相比，男性个体的终生精神健康障碍患病率（86%；95% CI，74-92）显着更高。估计了几种特定疾病的患病率，包括任何物质使用障碍（44％）、反社会人格障碍（26％）、重度抑郁症（19％）、精神分裂症（7％）和双相情感障碍（8％）。结论和相关性研究结果表明，大多数无家可归者患有精神健康障碍，其患病率高于一般社区样本中观察到的患病率。需要采取具体干预措施来支持这一人群的心理健康需求，包括密切协调心理健康、社会和住房服务以及政策，以支持患有精神障碍的无家可归者。