Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, United States; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, United States; Department of Veterans Affairs VISN 21 Mental Illness Research, Education, and Clinical Center, San Francisco, CA, United States.
Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, United States; UCLA Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, United States.
Schizophr Res. 2018 Jul;197:421-427. doi: 10.1016/j.schres.2018.02.023. Epub 2018 Feb 24.
Homeless persons with psychosis are particularly susceptible to unsheltered homelessness, which includes living on the streets, in cars, and other places not meant for human habitation. Homeless persons with psychosis have distinct barriers to accessing care and comprise a high-need and hard-to-serve homeless subpopulation. Therefore, this study sought to understand unsheltered homelessness in persons with psychosis and its relationship to cognitive impairment, clinical symptoms, and community functioning, examined both categorically and dimensionally. This study included 76 homeless participants with a history of a psychotic diagnosis who were enrolled in a supported housing program but had not yet received housing. This study used two different housing stability thresholds (literally homeless at any point vs. literally homeless >20% of days) for comparing homeless Veterans with psychosis living in sheltered versus unsheltered situations on cognition, clinical symptoms, and community integration. Dimensional analyses also examined the relationship between percentage of days spent in unsheltered locations and cognition, clinical symptoms, and community integration. Sheltered and unsheltered Veterans with psychosis did not differ on clinical symptoms or community integration, but there was an inconsistent group difference on cognition depending on the threshold used for determining housing stability. In the unsheltered group, cognitive deficits in overall cognition, visual learning, and social cognition were related to more days spent in unsheltered locations. Rehabilitation efforts targeting specific cognitive deficits may be useful to facilitate greater access to care and successful interventions in this population.
患有精神病的无家可归者特别容易无家可归，包括住在街上、汽车里和其他不适合人类居住的地方。患有精神病的无家可归者在获得护理方面存在明显障碍，他们是一个高需求和难以服务的无家可归者亚群体。因此，本研究旨在了解精神病患者的无家可归状况及其与认知障碍、临床症状和社区功能的关系，从分类和维度两个方面进行了研究。本研究包括 76 名有精神病诊断史的无家可归者，他们参加了一个支持性住房项目，但尚未获得住房。本研究使用了两种不同的住房稳定阈值（任何时候都无家可归与>20%的时间无家可归）来比较有精神病的无家可归退伍军人在有 sheltered 和 unsheltered 情况下的认知、临床症状和社区融合情况。维度分析还研究了在 unsheltered 地点度过的天数与认知、临床症状和社区融合之间的关系。有 sheltered 和 unsheltered 精神病退伍军人在临床症状或社区融合方面没有差异，但根据确定住房稳定的阈值，认知方面存在不一致的群体差异。在 unsheltered 组中，总体认知、视觉学习和社会认知方面的认知缺陷与在 unsheltered 地点度过的天数有关。针对特定认知缺陷的康复努力可能有助于促进该人群获得更多的护理和成功的干预。
