The Association of Traumatic Brain Injury with Neurologic and Psychiatric Illnesses among Individuals Experiencing Homelessness: A Systematic Review and Meta-analysis

Homeless individuals are more likely than others to experience a traumatic brain injury (TBI), but it is uncertain if such individuals are more likely to experience neuropsychiatric illnesses.A systematic review was performed with searches in Medline, Embase, and PsychINFO for studies reporting on homeless persons with TBI and neuropsychiatric illnesses. A random-effects model was used to calculate odds ratios for having any neuropsychiatric diagnosis.Of 420 articles indexed, 19 were included for systematic review and 17 for meta-analysis reporting on 11,474 and 8,757 individuals, respectively. The pooled odds of a homeless individual with a TBI having any neurologic illness were 2.57 (95% CI [1.97, 3.44]; I2 = 68.0%) and 2.01 (95% CI [1.81, 2.25]; I2 = 79.2%) for any psychiatric illness.The odds of having a neuropsychiatric illness among homeless individuals with TBI are substantially higher than in the domiciled population with TBI.