Homelessness among individuals with psychotic disorders hospitalized for the first time: Findings from the Suffolk County Mental Health Project
Homelessness among individuals with psychotic disorders hospitalized for the first time: Findings from the Suffolk County Mental Health Project
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DOI：
10.1176/ajp.155.1.109
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发表时间：
1998-01-01
影响因子：
17.7
通讯作者：
Bromet, EJ
中科院分区：
文献类型：
--
作者：
Herman, DB;Susser, ES;Bromet, EJ
目的：尽管数据显示严重精神障碍患者的无家可归现象既令人痛苦又普遍，但几个重要的流行病学问题仍未得到解答。作者还比较了不同诊断组和不同症状组之间的无家可归率。方法：这项研究基于纽约长岛东部12个住院机构中10个医院的237名首次住院患者的数据。共识诊断来自多种信息来源，包括DSM-III-R的结构化临床访谈。患者在初次访问后进行了24个月的跟踪调查。无家可归史是基于受试者的自我报告。结果：15%的患者在第一次精神科住院之前或24个月内经历过至少一次无家可归。在其中三分之二以上的病例中，最初的无家可归事件发生在第一次住院之前。不同诊断组间的无家可归风险有显著差异。在被诊断为精神分裂症和相关疾病的受试者中，那些阴性症状水平高的人比那些症状水平低的人院前无家可归的风险要大得多。结论：观察到的高无家可归率必须引起临床医生、消费者的深切关注。政策制定者也是如此。这一发现支持了在精神障碍的早期进行访谈的重要性，特别是对被诊断为精神病的人。
Objective: Although data suggest that homelessness among persons with severe mental disorders is both distressing and common, several important epidemiologic questions remain unanswered This study reports on the occurrence of homelessness in a quasi-representative sample of persons newly hospitalized with psychotic disorders. The authors also compared rates of homelessness in different diagnostic groups and among groups with differing symptom profiles. Method: The study was based on data from 237 first-admission patients hospitalized at 10 of the 12 inpatient facilities in eastern Long Island N.Y. Consensus diagnoses were derived from multiple sources of information, including the Structured Clinical Interview for DSM-III-R. Patients were followed over a 24-month period after initial interview. Homelessness histories were based on subject self-reports. Results: Fifteen percent of the patients had experienced at least one episode of homelessness before or within 24 months of their first psychiatric hospitalization. In more than two-thirds of these cases, the initial homeless episode had occurred before the first hospitalization. There were Mo significant differences in the risk of homelessness among diagnostic groups. Among subjects diagnosed with schizophrenia and related disorders, those with high levels of negative symptoms had a significantly greater risk of prehospitalization homelessness than those with low symptom levels. Conclusions: The high rate of homelessness observed must be viewed with profound concern by clinicians, consumers? and policymakers alike. The findings support the importance of interviewing early in the course of disorder, particularly for persons diagnosed with psychotic illnesses.