Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs New England, Mental Illness Research and Education Clinical Center (MIRECC), West Haven, CT, USA; National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Yale Child Study Center, Yale University, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA.
J Psychiatr Res. 2023 Aug;164:118-124. doi: 10.1016/j.jpsychires.2023.05.062. Epub 2023 Jun 9.
Gambling disorder (GD) is often a concern for people living in poverty. Although GD has been correlated with homelessness, there has been no study of factors related to chronic homelessness among veterans with GD.
This study used data from specialized homeless programs from the U.S. Department of Veterans Affairs Homeless Operations Management System to explore prevalence and correlates of chronic homelessness among veterans with GD in this program and to describe initial descriptive epidemiology. Chi-square tests, analyses of variance, and logistic regressions were conducted to examine differences in sociodemographic, military, clinical, and behavioral characteristics between veterans with versus without chronic homelessness.
Of 6053 veterans with GD, 1733 (28.6%) had chronic homelessness. Veterans with versus without chronic homelessness were more likely to be older, male, unemployed, and of low educational attainment and report having spent fewer years in the military. Chronic homelessness was associated with elevated odds of mental health and medical diagnoses, traumatic experiences, incarceration, and suicidal thoughts. Veterans with versus without chronic homelessness more frequently reported needing substance use, medical and psychiatric treatments but expressed low interest in participation in psychiatric treatment.
Veterans with GD and chronic homelessness have more clinical and behavioral concerns and needs for treatment, but participate in treatment at lower rates. It may be important to address both chronic homelessness and GD concurrently in order to effectively support veterans facing these challenges.
赌博障碍（GD）通常是贫困人群关注的问题。尽管 GD 与无家可归有关，但尚未有研究探讨有 GD 的退伍军人中与长期无家可归相关的因素。
本研究使用了美国退伍军人事务部无家可归者运营管理系统中专门的无家可归者计划的数据，以探讨该计划中患有 GD 的退伍军人中慢性无家可归的患病率和相关因素，并描述初始描述性流行病学。采用卡方检验、方差分析和逻辑回归检验了患有与不患有慢性无家可归的退伍军人在社会人口学、军事、临床和行为特征方面的差异。
在 6053 名患有 GD 的退伍军人中，有 1733 名（28.6%）患有慢性无家可归。与不患有慢性无家可归的退伍军人相比，患有慢性无家可归的退伍军人更可能年龄较大、男性、失业、教育程度较低，并且报告在军队中服役的时间较短。慢性无家可归与心理健康和医疗诊断、创伤经历、监禁和自杀念头的几率增加有关。与不患有慢性无家可归的退伍军人相比，患有慢性无家可归的退伍军人更频繁地报告需要接受药物滥用、医疗和精神科治疗，但对参与精神科治疗的兴趣较低。
患有 GD 和慢性无家可归的退伍军人有更多的临床和行为问题以及治疗需求，但参与治疗的比例较低。为了有效地支持面临这些挑战的退伍军人，可能需要同时解决慢性无家可归和 GD 问题。
