Fekadu Abebaw, Hanlon Charlotte, Gebre-Eyesus Emebet, Agedew Melkamu, Solomon Haddis, Teferra Solomon, Gebre-Eyesus Tsehaysina, Baheretibeb Yonas, Medhin Girmay, Shibre Teshome, Workneh Abraham, Tegegn Teketel, Ketema Alehegn, Timms Philip, Thornicroft Graham, Prince Martin
BMC Med. 2014 Aug 20;12:138. doi: 10.1186/s12916-014-0138-x.
The impact of mental disorders among homeless people is likely to be substantial in low income countries because of underdeveloped social welfare and health systems. As a first step towards advocacy and provision of care, we conducted a study to determine the burden of psychotic disorders and associated unmet needs, as well as the prevalence of mental distress, suicidality, and alcohol use disorder among homeless people in Addis Ababa, the capital of Ethiopia.
A cross-sectional survey was conducted among street homeless adults. Trained community nurses screened for potential psychosis and administered standardized measures of mental distress, alcohol use disorder and suicidality. Psychiatric nurses then carried out confirmatory diagnostic interviews of psychosis and administered a locally adapted version of the Camberwell Assessment of Needs Short Appraisal Schedule.
We assessed 217 street homeless adults, about 90% of whom had experienced some form of mental or alcohol use disorder: 41.0% had psychosis, 60.0% had hazardous or dependent alcohol use, and 14.8% reported attempting suicide in the previous month. Homeless people with psychosis had extensive unmet needs with 80% to 100% reporting unmet needs across 26 domains. Nearly 30% had physical disability (visual and sensory impairment and impaired mobility). Only 10.0% of those with psychosis had ever received treatment for their illness. Most had lived on the streets for over 2 years, and alcohol use disorder was positively associated with chronicity of homelessness.
Psychoses and other mental and behavioural disorders affect most people who are street homeless in Addis Ababa. Any programme to improve the condition of homeless people should include treatment for mental and alcohol use disorders. The findings have significant implications for advocacy and intervention programmes, particularly in similar low income settings.
由于社会福利和卫生系统欠发达，低收入国家中精神障碍对无家可归者的影响可能相当大。作为宣传和提供护理的第一步，我们开展了一项研究，以确定埃塞俄比亚首都亚的斯亚贝巴无家可归者中精神障碍的负担及相关未满足的需求，以及精神痛苦、自杀倾向和酒精使用障碍的患病率。
对街头无家可归的成年人进行了一项横断面调查。经过培训的社区护士筛查潜在的精神病，并实施精神痛苦、酒精使用障碍和自杀倾向的标准化测量。然后，精神科护士对精神病进行确诊诊断访谈，并实施了当地改编版的《坎伯韦尔需求评估简短评定量表》。
我们评估了217名街头无家可归的成年人，其中约90%曾经历过某种形式的精神或酒精使用障碍：41.0%患有精神病，60.0%有危险或依赖酒精使用，14.8%报告在前一个月曾尝试自杀。患有精神病的无家可归者有大量未满足的需求，80%至100%的人报告在26个领域存在未满足的需求。近30%有身体残疾（视力和感官障碍以及行动能力受损）。只有10.0%的精神病患者曾接受过疾病治疗。大多数人在街头生活了两年多，酒精使用障碍与无家可归的长期性呈正相关。
精神病以及其他精神和行为障碍影响着亚的斯亚贝巴大多数街头无家可归者。任何改善无家可归者状况的项目都应包括对精神和酒精使用障碍的治疗。这些发现对宣传和干预项目具有重要意义，尤其是在类似的低收入环境中。
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