Craig T K, Hodson S
Division of Psychiatry & Psychology, St Thomas' Hospital, London.
Psychol Med. 2000 Jan;30(1):187-94. doi: 10.1017/s0033291799001488.
While there is considerable evidence of a high prevalence of psychiatric disorder among homeless youth, much less is known about its long-term course or the impact it may have on accommodation outcomes.
A random sample of 161 homeless people 16-21 years of age were recruited from consecutive attendees at two of London's largest facilities for homeless young people. These young people were traced and re-interviewed a year later to examine accommodation, occupation and health outcomes.
A total of 107 (67%) people were successfully re-interviewed. Psychiatric disorder was identified in 55% at follow up. Two thirds of those with a psychiatric disorder at index interview remained symptomatic at follow-up. Persistence of psychiatric disorder was associated with adverse childhood experiences and rough sleeping. Satisfactory accommodation outcomes were achieved by 45 subjects (42%). Better accommodation outcomes were associated with three variables measured at the index assessment: ethnic minority status; educational achievement; and, the presence of accommodation plans negotiated through a resettlement agency. While psychiatric disorder at index interview was not associated with accommodation outcome, persistent substance use in the follow-up year was associated with poor accommodation outcome. Over half of the young people had been involved in petty crime and just under a third had been convicted for more serious criminal activity. Offending and antisocial behaviour in the follow-up year were related to a history of conduct disorder, persistent substance abuse and poor accommodation outcomes.
Young homeless people are characterized by multiple social and medical needs. Successful resettlement of this population may depend upon integrated services that address problems of persisting substance use and mental illness as well as the immediate housing need.
虽然有大量证据表明无家可归青少年中精神障碍患病率很高，但对其长期病程或对住宿结果可能产生的影响了解较少。
从伦敦两家最大的无家可归青少年收容机构的连续就诊者中随机抽取161名16至21岁的无家可归者。一年后对这些年轻人进行追踪并再次访谈，以检查住宿、职业和健康状况。
共有107人（67%）成功接受了再次访谈。随访时发现55%的人患有精神障碍。初次访谈时有精神障碍的人中有三分之二在随访时仍有症状。精神障碍的持续存在与童年不良经历和露宿有关。45名受试者（42%）取得了满意的住宿结果。更好的住宿结果与初次评估时测量的三个变量有关：少数族裔身份；教育成就；以及通过重新安置机构协商的住宿计划。虽然初次访谈时的精神障碍与住宿结果无关，但随访年度持续使用毒品与不良住宿结果有关。超过一半的年轻人曾参与轻微犯罪，近三分之一的人因更严重的犯罪活动被定罪。随访年度的犯罪和反社会行为与品行障碍史、持续药物滥用和不良住宿结果有关。
无家可归的年轻人具有多种社会和医疗需求。这一人群的成功重新安置可能取决于综合服务，该服务要解决持续存在的药物使用和精神疾病问题以及即时住房需求。
