Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA, 01605, USA.
School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA.
Community Ment Health J. 2019 Nov;55(8):1305-1312. doi: 10.1007/s10597-019-00432-6. Epub 2019 Jun 24.
This study explored patterns of clinical need among homeless individuals with dual diagnoses, and explored whether certain profiles are characteristic of different demographic groups. Data were drawn from two larger studies conducted with dually diagnosed, homeless individuals (n = 373). Hierarchical cluster analysis identified four subgroups: (1) Clinically least severe, characterized by less frequent psychological symptoms and no history of physical or sexual abuse; (2) Moderate clinical needs, including shorter history of substance use and less frequent psychological symptoms, but symptoms consistent with severe mental illness; (3) Clinically severe, with frequent anxiety, depression, past and recent physical or sexual abuse, and long history of substance use; (4) Least frequent psychological symptoms, but frequent history of physical or sexual abuse and long history of drug use. Women veterans were mostly likely to be classified in cluster 3, and male civilians in cluster 2. Subgroups of homeless individuals with dual diagnoses demonstrated different clusters of clinical needs, having implications for service delivery to the population.
本研究探讨了双重诊断的无家可归者的临床需求模式，并探讨了某些特征是否是不同人群的特征。数据来自两项针对双重诊断的无家可归者（n=373）进行的较大型研究。分层聚类分析确定了四个亚组：（1）临床症状最不严重，表现为心理症状不频繁，没有身体或性虐待史；（2）中等临床需求，包括较短的物质使用史和较少的心理症状，但症状与严重精神疾病一致；（3）临床严重，有频繁的焦虑、抑郁、过去和现在的身体或性虐待，以及长期的物质使用史；（4）心理症状最不频繁，但有频繁的身体或性虐待史和长期的药物使用史。女性退伍军人最有可能被归类为第 3 组，而男性平民则被归类为第 2 组。具有双重诊断的无家可归者亚组表现出不同的临床需求集群，这对该人群的服务提供具有重要意义。
