1 Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
2 Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
Int J Soc Psychiatry. 2017 Sep;63(6):525-531. doi: 10.1177/0020764017714494. Epub 2017 Jun 27.
A significant number of homeless mentally ill (HMI) patients without any personal, family or other identification details represent a unique problem in the psychiatric services of developing countries like India in the context of legal, humanitarian and treatment issues. These patients pose challenge to the mental health professional in diagnosis and management.
To study the sociodemographic and clinical profiles of HMI patients admitted under psychiatry.
We performed a retrospective chart review of 'HMI' patients from 1 January 2002 to 31 December 2015, who were admitted to the Department of Psychiatry at National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Sociodemographic and clinical profiles of the patients were analyzed by descriptive statistics.
Mean age of the sample was 34.6 years (±12.21 years), 42 (53.8%) were females, 74 (94.9%) were registered as Medico Legal Case and 53 (80.8%) were admitted under reception order issued by a magistrate. HMI patients brought by police were 32 (41.0%), by the public were 32 (41.0%) and 14 (18.0%) by nongovernmental organization /ambulance/social worker. In total, 51 (65.4%) of them had schizophrenia and other psychotic disorders, 24 (30.8%) had mental retardation and 23 (29.5%) had a comorbid substance use disorder. The mean Clinical Global Impression severity at admission was 5.07 (±1.7), and the mean duration of inpatient care was 15 weeks. Anemia and malnutrition were found in 34 (43.6%) and 25 (32.1%) patients, respectively.
This study shows that schizophrenia, comorbid mental retardation and substance use disorder are common causes of admission of HMI patients in psychiatry. It is an emerging problem, which needs urgent interventions, and there is a need for an efficient system, guidelines and collaboration with government and nongovernmental agencies.
在法律、人道主义和治疗问题方面，在印度等发展中国家的精神科服务中，大量没有任何个人、家庭或其他身份识别细节的无家可归的精神病患者（HMI）代表着一个独特的问题。这些患者对精神卫生专业人员的诊断和管理构成了挑战。
研究精神科收治的 HMI 患者的社会人口学和临床特征。
我们对 2002 年 1 月 1 日至 2015 年 12 月 31 日期间在印度班加罗尔国家心理健康和神经科学研究所（NIMHANS）精神科住院的“HMI”患者进行了回顾性病历审查。采用描述性统计方法分析患者的社会人口学和临床特征。
样本的平均年龄为 34.6±12.21 岁，42 名（53.8%）为女性，74 名（94.9%）被登记为法医案件，53 名（80.8%）根据治安法官签发的接待令入院。由警察送来的 HMI 患者有 32 名（41.0%），由公众送来的有 32 名（41.0%），由非政府组织/救护车/社会工作者送来的有 14 名（18.0%）。共有 51 名（65.4%）患者患有精神分裂症和其他精神病性障碍，24 名（30.8%）患有智力迟钝，23 名（29.5%）患有合并物质使用障碍。入院时的临床总体印象严重程度平均为 5.07（±1.7），住院治疗平均持续 15 周。34 名（43.6%）患者存在贫血，25 名（32.1%）患者存在营养不良。
本研究表明，精神分裂症、合并智力迟钝和物质使用障碍是精神科收治 HMI 患者的常见原因。这是一个亟待解决的新问题，需要紧急干预，同时需要建立一个有效的系统、指南并与政府和非政府机构合作。
