1 University College London, UK.
2 Kensington & Chelsea Learning Disability Service, UK.
Autism. 2019 Apr;23(3):665-676. doi: 10.1177/1362361318768484. Epub 2018 Apr 10.
Anecdotal evidence suggests that autistic people experience an elevated risk of homelessness, but systematic empirical research on this topic is lacking. As a step towards filling this gap in knowledge, we conducted a preliminary investigation of the prevalence of Diagnostic and Statistical Manual of Mental Disorders (5th ed.) autism symptoms in a group of long-term homeless people. The entire caseload ( N = 106) of a UK homeless outreach team was screened (excluding individuals born outside of the United Kingdom or Republic of Ireland) using an in-depth, semi-structured interview with keyworkers, based on Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnostic criteria. This showed adequate inter-rater reliability, as well as evidence of criterion and construct validity. Of the sample, 13 people (12.3%, 95% confidence interval (7.0, 20.4)) screened positive, meeting Diagnostic and Statistical Manual of Mental Disorders (5th ed.) autism criteria by keyworker report. A further nine people (8.5%, 95% confidence interval (4.5, 15.3)) were 'marginal', having autistic traits that were not quite sufficient to meet Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria. Those with elevated autistic traits, compared to those without, tended to be more socially isolated and less likely to use substances. This study has provided initial evidence that autistic traits are over-represented among homeless people and that autistic homeless people may show a distinct pattern of characteristics and needs. Further investigation is required to build upon these provisional findings.
有传闻证据表明，自闭症患者面临更高的无家可归风险，但针对这一主题的系统实证研究却很缺乏。为了填补这一知识空白，我们初步调查了一组长期无家可归者中《精神障碍诊断与统计手册》（第五版）自闭症症状的患病率。英国一个无家可归者外展团队的所有案例（不包括在英国或爱尔兰出生的人）都接受了工作人员的深入半结构化访谈，该访谈基于《精神障碍诊断与统计手册》（第五版）的诊断标准。结果显示，该方法具有较好的组内一致性，并且具有标准和结构有效性的证据。在该样本中，有 13 人（12.3%，95%置信区间（7.0，20.4））经工作人员报告符合《精神障碍诊断与统计手册》（第五版）自闭症标准，筛查结果呈阳性。另有 9 人（8.5%，95%置信区间（4.5，15.3））为“边缘”状态，他们具有自闭症特征，但不足以符合《精神障碍诊断与统计手册》（第五版）的标准。与没有自闭症特征的人相比，具有自闭症特征的人往往更加孤立，且不太可能使用物质。本研究初步表明，自闭症特征在无家可归者中较为常见，自闭症无家可归者可能表现出独特的特征和需求模式。需要进一步的研究来验证这些初步发现。
