Substance Dependence Among Bipolar, Unipolar Depression and Psychotic Homeless

A Canadian National Study

Bibliographic Data

ID15525593
AuthorsAngelo Giovanni Icro Maremmani (0000-0001-7728-3705, Regione Toscana, corresponding author), Silvia Bacciardi (University of Pisa), Julian M Somers (Simon Fraser University), Mohammadali Nikoo (0000-0002-7692-3923, BC Mental Health & Substance Use Services), Christian G Schütz (0000-0002-5445-8290, BC Mental Health & Substance Use Services), Christian Schütz, Kerry L Jang (0000-0002-0977-5377, University of British Columbia), Michael Krausz (0000-0002-3509-7274, St. Paul's Hospital)
Year2018
Volume9
Pages701-701
Publication date2018-12-18
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Psychiatry (JOURNAL)
Journal identifiersISSN: 1664-0640 • E-ISSN: 1664-0640
PublisherFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2018.00701
PMID30618874
OpenAlexW2905301814
LanguageEN
Citations received2
References cited64

Introduction: Homeless individuals are often mischaracterized as members of a homogeneous population that suffers from a wide mental health and addiction issues, with little consideration of potentially important differences within or between samples. The aim of the present study was to investigate the comorbidy of alcohol and/or substance dependence (ASD) and major psychiatric diagnoses (bipolar disorder, unipolar depression, and psychotic disorder) in a large Canadian sample of homeless individuals, and to examine potential sources of variability including location and ethnicity. Materials and Methods: A sample of 1,585 homeless individuals were assessed for alcohol and/or substance dependence and bipolar disorder, unipolar depression and psychotic disorder with the Mini-International Neuropsychiatric Interview (version 6.0). Regional and ethnic differences in major psychiatric diagnoses between homeless with and without ASD were examined using univariate (i.e., chi-square) and multivariate (i.e., logistic regression) statistics. Results: Members of the sample with ASD were found to be younger, Aboriginal, less well-educated, and born in the Americas. They were more significantly more prevalent in Western Canada and less prevalent in Central and Eastern Canada. The odds of having ASD were higher among people affected by bipolar disorder and (to a less extent) unipolar depression. Limitations: Data collected were self-reported and no urinalyses were performed. We considered diagnosis of ASD according to the previous 12 months only. Conclusions: Homeless people with major mental illness are at high risk for concurrent ASD, however the prevalence of ASD varies significantly between cities, and based on ethnicity and specific psychiatric diagnosis (with greater prevalence in individuals affected by bipolar disorder and, to a less extent, unipolar depression). Clinicians, administrators and policy makers should develop and deliver services based on careful assessment of the local population

Alcohol · Alcohol dependence · Anxiety · Bipolar disorder · Depression (economics · Environmental health · Ethnic group · Logistic regression · Mental health · Mental illness · Mini-international neuropsychiatric interview · Mood · Population · Psychiatry · Bipolar Disorder and Treatment · Clinical Psychology · Homelessness and Social Issues · Medicine · Psychology · Substance Abuse Treatment and Outcomes

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