Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (UMRS 1136), Équipe de Recherche en Épidémiologie Sociale, F75012, Paris, France.
Direction des régions, Santé Publique France, France.
J Affect Disord. 2018 Mar 15;229:314-321. doi: 10.1016/j.jad.2017.12.053. Epub 2018 Jan 6.
Women are disproportionately likely to suffer from depression. This is especially true for those who experience socioeconomic hardship, such as homelessness. In France, among homeless mothers many are migrant. However, it is not clear whether risk factors associated with depression are specific for this group or the same as in the general population. Our objective was to describe socio-demographic, relational, living and housing conditions and health factors associated with depression among homeless mothers.
The ENFAMS survey, conducted via face-to-face bilingual interviews with a representative sample of homeless families in the Paris region (January-May 2013, n = 733 mothers). Mothers reported their socio-demographic characteristics, housing conditions including residential mobility, as well as physical and mental health. Depression was ascertained using the Composite International Diagnostic Interview (CIDI). Factors associated with mother's depression were studied in weighted Poisson regression models with robust error variance.
The prevalence of depression among participating mothers was 28.8%. In multivariate analyses, depression was associated with fluency in French (PR = 1.88 95% CI 1.40; 2.51), suicide risk (PR = 2.26, 95% CI 1.82; 2.82), post-traumatic stress disorder (PR = 1.97, 95% CI 1.50; 2.60), and unmet health needs (PR = 1.68, 95% CI 1.09; 2.57).
Homeless mothers have high levels of depression and associated psychiatric comorbidities. Associated risk factors appear to be both specific for this group and shared with mothers in the general population. Improvements in the monitoring of mental health difficulties as well as access to appropriate medical care in this vulnerable population may help improve health and social outcomes.
女性患抑郁症的比例不成比例。对于那些经历社会经济困难的人来说，情况尤其如此，例如无家可归者。在法国，无家可归的母亲中有许多是移民。然而，目前尚不清楚与抑郁症相关的风险因素是否特定于这一群体，或者与普通人群相同。我们的目的是描述与无家可归的母亲抑郁相关的社会人口统计学、关系、生活和住房条件以及健康因素。
通过面对面的双语访谈，对巴黎地区的无家可归家庭进行了代表性样本的 ENFAMS 调查（2013 年 1 月至 5 月，n = 733 名母亲）。母亲报告了她们的社会人口统计学特征、住房条件，包括居住流动性，以及身心健康状况。使用复合国际诊断访谈（CIDI）确定抑郁症。使用加权泊松回归模型和稳健误差方差研究与母亲抑郁相关的因素。
参与母亲的抑郁症患病率为 28.8%。在多变量分析中，抑郁症与法语流利程度（PR = 1.88，95%CI 1.40；2.51）、自杀风险（PR = 2.26，95%CI 1.82；2.82）、创伤后应激障碍（PR = 1.97，95%CI 1.50；2.60）和未满足的健康需求（PR = 1.68，95%CI 1.09；2.57）相关。
无家可归的母亲患有严重的抑郁症和相关的精神共病。相关的风险因素似乎既特定于这一群体，也与普通人群中的母亲共享。改善对这一弱势群体心理健康困难的监测以及获得适当的医疗保健，可能有助于改善健康和社会结果。
