Kovess V, Mangin Lazarus C
MGEN Research Laboratory, Paris V University, France.
Soc Psychiatry Psychiatr Epidemiol. 1999 Nov;34(11):580-7. doi: 10.1007/s001270050178.
Homelessness is a growing problem in the cities of the western world, and homeless people have a plethora of mental health and social difficulties. These are, nevertheless, difficult to evaluate epidemiologically.
In this paper we present a population survey using the Composite International Diagnostic Interview (CIDI) conducted in the city of Paris in winter 1996 on a representative sample of 838 homeless people. Night shelters as well as food kitchens were randomly sampled, and the mean response rate was around 65%.
The sample was relatively young and predominantly male (85%). Forty percent were born outside France, 96% had worked at some time, and one-third reported no resources at all. The lifetime prevalence of psychiatric disorders was 57.9%, while the 1-year prevalence was 29.1%. For definite psychotic disorders, prevalence was 16% (lifetime) and 6% (1 year). Generally, this Parisian homeless population had some access to care: in the preceding 6 months 57.7% of them had been medically attended and 14.2% of these had been hospitalised. The survey was cross-sectional, and did not evaluate regular access to care or the quality of care.
The implications for health and social systems are discussed in the light of comparisons with European and North American data.
在西方世界的城市中，无家可归问题日益严重，无家可归者面临着众多心理健康和社会方面的困难。然而，从流行病学角度对这些困难进行评估却很困难。
在本文中，我们介绍了一项于1996年冬季在巴黎市进行的人口调查，该调查使用了综合国际诊断访谈（CIDI），样本为838名无家可归者的代表性样本。夜间收容所和施粥处均为随机抽样，平均回应率约为65%。
样本相对年轻，男性占主导（85%）。40%出生在法国境外，96%曾有过工作经历，三分之一的人表示完全没有收入来源。精神障碍的终生患病率为57.9%，而1年患病率为29.1%。确诊的精神病性障碍患病率为16%（终生）和6%（1年）。总体而言，巴黎的这些无家可归者有一定的就医渠道：在过去6个月里，57.7%的人接受过医疗护理，其中14.2%的人曾住院治疗。该调查为横断面调查，未评估获得常规护理的情况或护理质量。
结合与欧洲和北美数据的比较，讨论了对卫生和社会系统的影响。
