Zabkiewicz Denise M, Patterson Michelle, Wright Alexandra
Faculty of Health Sciences, Centre for Applied Research in Mental Health & Addiction, Simon Fraser University, Burnaby, British Columbia, Canada.
Centre for International Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia.
BMJ Open. 2014 Dec 8;4(12):e006174. doi: 10.1136/bmjopen-2014-006174.
This study draws on baseline data from the At Home/Chez Soi demonstration project to examine the association between parenting status and mental health among homeless women and whether the association varies by duration of homelessness.
Structured interviews were conducted with participants in five cities across Canada including Moncton, Montreal, Toronto, Vancouver and Winnipeg.
Eligibility criteria included those with legal adult status, with a mental illness, and who lacked a regular, fixed shelter. All 713 women who participated in the larger project were selected for inclusion in this analysis.
The mental health conditions of interest include depression, post-traumatic stress disorder (PTSD), alcohol dependence and substance dependence.
The relationship between parenting status and depression, as well as PTSD, varied by duration of homelessness. Among women who had been homeless for less than 2 years, no relationship was found between parenting status and depression, or PTSD. However, among women who had been homeless for 2 or more years, the odds of depression was twice as high among parenting women compared with others (aOR=2.05, p≤0.05). A similar relationship was found between parenting status and PTSD (aOR=2.03, p≤0.05). The odds of substance dependence was found to be 2.62 times greater among parenting women compared with others and this relationship did not vary by duration of homelessness (aOR=2.62; 95% CI 1.86 to 3.69). No relationship was found between parenting and alcohol dependence.
Overall, the findings from this study suggest that there is a relationship between long-term homelessness and mothers' risk of poor mental health. Given the multiple demands mothers face, a failure to recognise their unique needs is likely to contribute to intergenerational legacies of homelessness and mental health problems.
World Health Organization's International Clinical Trials Registry Platform (ISRCTN66721740 and ISRCTN57595077).
本研究利用“在家/ chez Soi”示范项目的基线数据，以检验无家可归女性的育儿状况与心理健康之间的关联，以及这种关联是否因无家可归的持续时间而异。
对加拿大五个城市（包括蒙克顿、蒙特利尔、多伦多、温哥华和温尼伯）的参与者进行了结构化访谈。
入选标准包括具有法定成年人身份、患有精神疾病且缺乏常规固定住所的人。参与该大型项目的所有713名女性均被纳入本分析。
所关注的心理健康状况包括抑郁症、创伤后应激障碍（PTSD）、酒精依赖和物质依赖。
育儿状况与抑郁症以及创伤后应激障碍之间的关系因无家可归的持续时间而异。在无家可归时间少于2年的女性中，未发现育儿状况与抑郁症或创伤后应激障碍之间存在关联。然而，在无家可归2年或更长时间的女性中，育儿女性患抑郁症的几率是其他女性的两倍（调整后比值比[aOR]=2.05，p≤0.05）。在育儿状况与创伤后应激障碍之间也发现了类似的关系（aOR=2.03，p≤0.05）。发现育儿女性的物质依赖几率比其他女性高2.62倍，且这种关系不因无家可归的持续时间而变化（aOR=2.62；95%置信区间为1.86至3.69）。未发现育儿与酒精依赖之间存在关联。
总体而言，本研究结果表明长期无家可归与母亲心理健康状况不佳的风险之间存在关联。鉴于母亲们面临的多重需求，未能认识到她们的独特需求可能会导致无家可归和心理健康问题的代际遗留问题。
世界卫生组织国际临床试验注册平台（ISRCTN66721740和ISRCTN57595077）。
