Prevalence of attention deficit hyperactivity disorder in homeless children and adolescents: A systematic review and meta-analysis

Introduction: This systematic review and meta-analysis aimed to examine the prevalence of Attention deficit hyperactivity disorder (ADHD) in homeless children and adolescents, and the factors that may influence its prevalence. Methods: Relevant publications in Medline, Web of Science, Scopus and PsycINFO were systematically searched to identify studies on the prevalence of ADHD in homeless children and adolescents (<= 19 years). The extracted data were pooled using a random-effects model. Results: Thirteen studies involving 2878 homeless children and adolescents were included (mean age: 12.0 years, sex F/M: 0.43). The prevalence rates of ADHD vary considerably across studies, ranging from 1.6% to 64.5%. The pooled prevalence of ADHD was 22.8% (95% CI 12.9-34.4%, I2 =98%). Meta-regression analyses indicated that age (slope = 0.046; p = .042) significantly increased ADHD prevalence. The prevalence of ADHD in studies with a mean age >= 12 years (43.1%, 95% CI 26.5-60.4%) was higher than those with a mean age < 12 years (13.1%, 95%CI 4.3-25.6). Conclusion: Despite the high heterogeneity of the studies, we observed that ADHD could affect almost a quarter of homeless children and adolescents. Reintegrating them into care systems and ensuring access to public health interventions tailored for homeless families and youth is imperative for breaking the cycle of homelessness and improving long-term trajectories.