Department of Psychiatry, Columbia University, New York City, NY, USA.
Psychiatr Serv. 2012 Sep 1;63(9):906-12. doi: 10.1176/appi.ps.201100405.
Although foster care placement is often preceded by stressful events such as child abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults.
A consecutive sample of 423 adults aged 18 to 21 years who sought emergency shelter for the first time between October 1, 2007, and February 29, 2008, were assessed at intake. Logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, and psychotic) and psychiatric treatment. The analyses adjusted for demographic characteristics, childhood abuse, substance use, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives.
Homeless young adults with histories of foster care were 70% more likely than those without such histories to report any psychiatric disorder. They were more than twice as likely to have received mental health counseling for a psychiatric disorder, to have been prescribed psychiatric medication, and to have been hospitalized for psychiatric problems.
Histories of foster care among homeless young adults should trigger screening for psychiatric disorders to aid in the provision of treatment (counseling, medication, and hospitalization) tailored to the psychiatric needs of this highly vulnerable population.
尽管寄养安置通常发生在虐待儿童等压力事件之前,但寄养本身往往会使儿童面临更多的严重压力源。无家可归的年轻成年人中,常有寄养经历和随之而来的童年虐待史。本研究调查了寄养经历是否与新无家可归的年轻成年人的精神障碍、先前的精神科咨询、精神科药物处方和先前的精神科住院治疗有关。
2007 年 10 月 1 日至 2008 年 2 月 29 日期间,对首次寻求紧急庇护所的 423 名年龄在 18 至 21 岁之间的成年人进行了连续抽样评估。逻辑回归分析确定了寄养与任何精神障碍(情感、焦虑、人格和精神病性)和精神科治疗之间的关联。分析调整了人口统计学特征、儿童虐待、物质使用、先前被捕、失业、缺乏高中文凭以及生物亲属的精神障碍和药物滥用史。
有寄养经历的无家可归的年轻成年人报告任何精神障碍的可能性比没有这种经历的人高 70%。他们接受精神科疾病心理咨询、开精神科药物处方和因精神科问题住院的可能性是没有寄养经历者的两倍多。
无家可归的年轻成年人的寄养经历史应引发对精神障碍的筛查,以帮助提供针对这一高度脆弱人群的精神科需求的治疗(咨询、药物和住院治疗)。