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<p>Global homelessness is a rapidly increasing humanitarian crisis, affecting 120 million individuals worldwide. However, the prevalence of mental disorders in homeless young people globally is unknown; our study aimed to address this gap. In this systematic review and meta-analysis, we searched PubMed, Embase, Scopus and Web of Science from January 1990 to 16 October 2024 for research articles in any language that reported any mental disorders for the homeless under the mean age of 24 years by reliable diagnostic methods. Studies with a response rate &lt;50%, a sample size &lt;50 and those that did not report the original data were excluded. Subgroup analyses and meta-regression were conducted to examine the potential factors influencing heterogeneity of prevalence. The study was registered with PROSPERO (CRD42024570399). Of the 33,600 reports identified, 45 from nine countries (73.3% from the USA) were included in this systematic review and meta-analyses. The studies encompassed 25,320 participants: 50.5% male and 48.3% female. The random-effects meta-analysis of mental disorders indicated that substance use disorders had the highest pooled point prevalence among homeless children, adolescents and youth (29.2% (95% CI 17.7–42.3%)), followed by conduct disorder (24.4% (95% CI 8.3–45.4%)), depressive disorders (21.3% (95% CI 16.7–26.4%)), anxiety disorders (16.3% (95% CI 9.9–23.9%)), posttraumatic stress disorder (14.8% (95% CI 10.8–19.3%)), bipolar and related disorders (13.0% (95% CI 4.8–24.2%)), ADHD (12.9% (95% CI 7.5–19.5%)) and schizophrenia spectrum disorders (5.4% (95% CI 1.8–10.6%)). The lifetime prevalence ranged from 12.5% (anxiety disorders) to 71.5% (conduct disorder). Subgroup and meta-regression analyses revealed key gaps: small samples, few post 2020 studies and major underrepresentation of Asian and African populations. Individuals aged 18–24 were at higher clinical risk. Conduct, anxiety and substance use disorders were more common in males; depressive disorders were more common in females. Overall, homeless children, adolescents and youth face markedly elevated risks for mental disorders, especially substance use and conduct disorders. Urgent, integrative tertiary prevention interventions and further research are needed to support this vulnerable group.</p>

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A systematic review and meta-analysis of mental disorders in homeless children, adolescents and youths

  • 期刊论文

  • 发表日期：

    2026年4月2日

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  • Lingxue Luo,
  • Kangpeng Li,
  • Xinyu Zhou,
  • Yanping Bao,
  • Lin Lu,
  • Suhua Chang

摘要

Global homelessness is a rapidly increasing humanitarian crisis, affecting 120 million individuals worldwide. However, the prevalence of mental disorders in homeless young people globally is unknown; our study aimed to address this gap. In this systematic review and meta-analysis, we searched PubMed, Embase, Scopus and Web of Science from January 1990 to 16 October 2024 for research articles in any language that reported any mental disorders for the homeless under the mean age of 24 years by reliable diagnostic methods. Studies with a response rate <50%, a sample size <50 and those that did not report the original data were excluded. Subgroup analyses and meta-regression were conducted to examine the potential factors influencing heterogeneity of prevalence. The study was registered with PROSPERO (CRD42024570399). Of the 33,600 reports identified, 45 from nine countries (73.3% from the USA) were included in this systematic review and meta-analyses. The studies encompassed 25,320 participants: 50.5% male and 48.3% female. The random-effects meta-analysis of mental disorders indicated that substance use disorders had the highest pooled point prevalence among homeless children, adolescents and youth (29.2% (95% CI 17.7–42.3%)), followed by conduct disorder (24.4% (95% CI 8.3–45.4%)), depressive disorders (21.3% (95% CI 16.7–26.4%)), anxiety disorders (16.3% (95% CI 9.9–23.9%)), posttraumatic stress disorder (14.8% (95% CI 10.8–19.3%)), bipolar and related disorders (13.0% (95% CI 4.8–24.2%)), ADHD (12.9% (95% CI 7.5–19.5%)) and schizophrenia spectrum disorders (5.4% (95% CI 1.8–10.6%)). The lifetime prevalence ranged from 12.5% (anxiety disorders) to 71.5% (conduct disorder). Subgroup and meta-regression analyses revealed key gaps: small samples, few post 2020 studies and major underrepresentation of Asian and African populations. Individuals aged 18–24 were at higher clinical risk. Conduct, anxiety and substance use disorders were more common in males; depressive disorders were more common in females. Overall, homeless children, adolescents and youth face markedly elevated risks for mental disorders, especially substance use and conduct disorders. Urgent, integrative tertiary prevention interventions and further research are needed to support this vulnerable group.