Koegel P, Burnam M A, Farr R K
Department of Psychiatry and Biobehavioral Sciences, UCLA.
Arch Gen Psychiatry. 1988 Dec;45(12):1085-92. doi: 10.1001/archpsyc.1988.01800360033005.
Lifetime and current prevalence of Diagnostic Interview Schedule/DSM-III disorders were determined for a probability sample of homeless adults in the Skid Row area of Los Angeles. Compared with findings from a household sample, prevalence was substantially higher for every disorder assessed. Rates of major mental illnesses were the most disproportionately high. Substance abuse was more highly prevalent among older individuals and Native Americans, while schizophrenia was most highly prevalent among those subjects between 31 and 40 years of age. Rates of both substance abuse and schizophrenia were elevated among individuals who had been homeless many times or for long periods of time. It was estimated that 28% of subjects in this inner-city homeless sample were chronically mentally ill, a percentage that was consistent with results of well-designed studies employing nondiagnostic standardized measures of mental illness, but lower than results of studies relying on clinical judgment to assess the prevalence of specific disorders. There is a need for simultaneous attention to the social welfare and mental health needs of homeless mentally ill individuals.
针对洛杉矶贫民窟地区无家可归成年人的概率样本,确定了《诊断访谈表》/《精神疾病诊断与统计手册》第三版(DSM-III)疾病的终生患病率和当前患病率。与家庭样本的研究结果相比,所评估的每种疾病的患病率都显著更高。主要精神疾病的发病率高得最为不成比例。药物滥用在老年人和美洲原住民中更为普遍,而精神分裂症在31至40岁的人群中最为普遍。多次或长期无家可归的个体中,药物滥用和精神分裂症的发病率均有所升高。据估计,这个市中心无家可归样本中的28%患有慢性精神疾病,这一比例与采用非诊断性标准化精神疾病测量方法的精心设计研究结果一致,但低于依靠临床判断来评估特定疾病患病率的研究结果。需要同时关注无家可归的精神病患者的社会福利和心理健康需求。