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Seizures and epilepsy in homeless patients : a systematic review
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Orientador(es)
Resumo(s)
Objetivos: Esta revisão sistemática pretende estimar a prevalência de convulsões e epilepsia em doentes sem-abrigo na literatura científica atual bem como rever as principais adversidades que este grupo enfrenta.
Métodos: Os termos “convulsões”, “epilepsia” e “sem abrigo”, associados a títulos e resumos de artigos, foram pesquisados através da plataforma PubMed entre 27 de outubro de 2021 e 9 de abril de 2022. Não foram aplicadas restrições de data ou tipo de publicação à pesquisa. Foram excluídos os artigos não escritos em língua inglesa, não referentes a áreas médicas, duplicados ou que não incluíssem os termos supracitados.
Resultados: Dos 43 artigos encontrados na pesquisa inicial, 1 duplicado foi excluído antes da revisão, 14 foram excluídos pela avaliação do título ou resumo e 3 foram excluídos pelos restantes critérios de exclusão (1 em língua não-inglesa, 2 de áreas não-médicas). Os 25 artigos remanescentes foram incluídos e analisados. Este estudo sugere que a prevalência de epilepsia na população sem-abrigo se encontra entre 1.75 e 30%, ao passo que a prevalência de sem-abrigo com epilepsia ronda valores entre os 1.8 e os 4%. Todos os estudos incluídos corroboram o aumento da prevalência de convulsões e epilepsia nos sem-abrigo, o que aumenta o risco global da doença, e de várias comorbilidades associadas.
Conclusões: São necessários mais estudos de forma a clarificar a distinção entre epilepsia primária e secundária neste grupo de doentes, que apresenta elevada incidência de fatores de confundimento para convulsões como abuso e privação de substâncias e traumatismo crânio-encefálico, e diminuir o fardo da epilepsia neste grupo tão desprotegido.
Objective: This review aims to estimate the prevalence of seizures and epilepsy among homeless patients in current literature as well as understand the main adversities that this group withstands. Methods: We conducted a search for “seizures”, “epilepsy” and “homeless” in articles’ titles and abstracts in PubMed through October 27th 2021 and April 9th 2022. No date or publication type restrictions were applied. Non-English language, non-medical, duplicates and articles that didn’t include the search words previously mentioned were excluded. Results: Of the 43 articles that matched our search, 1 duplicate was excluded before screening, 14 were excluded based on title and abstract review and 3 were excluded based on the remaining exclusion criteria. Overall, 25 articles met the final inclusion criteria and warranted analyses. This study suggests that the prevalence of epilepsy in the homeless population is between 1.75 and 30%, whereas the prevalence of homelessness in people with epilepsy is between 1.8 and 4%. Every study included in this review corroborates the increased prevalence of seizures and epilepsy among the homeless, which puts them at risk for worse outcomes related to this illness and numerous associated comorbidities. Conclusion: Further evidence is needed to clarify the distinction of primary and secondary seizures in this group, which shows a high rate of confounding factors for seizures like substance abuse/withdrawal and head injury, and to decrease the burden of epilepsy in an already resource-deficient community.
Objective: This review aims to estimate the prevalence of seizures and epilepsy among homeless patients in current literature as well as understand the main adversities that this group withstands. Methods: We conducted a search for “seizures”, “epilepsy” and “homeless” in articles’ titles and abstracts in PubMed through October 27th 2021 and April 9th 2022. No date or publication type restrictions were applied. Non-English language, non-medical, duplicates and articles that didn’t include the search words previously mentioned were excluded. Results: Of the 43 articles that matched our search, 1 duplicate was excluded before screening, 14 were excluded based on title and abstract review and 3 were excluded based on the remaining exclusion criteria. Overall, 25 articles met the final inclusion criteria and warranted analyses. This study suggests that the prevalence of epilepsy in the homeless population is between 1.75 and 30%, whereas the prevalence of homelessness in people with epilepsy is between 1.8 and 4%. Every study included in this review corroborates the increased prevalence of seizures and epilepsy among the homeless, which puts them at risk for worse outcomes related to this illness and numerous associated comorbidities. Conclusion: Further evidence is needed to clarify the distinction of primary and secondary seizures in this group, which shows a high rate of confounding factors for seizures like substance abuse/withdrawal and head injury, and to decrease the burden of epilepsy in an already resource-deficient community.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Sem-abrigo Convulsões Epilepsia Psiquiatria Psicologia médica