PDF
ePub
Citation
Print
Abstract
Objectives
This exploratory study was designed to estimate the socio-demographic characteristics, course of homelessness, adverse childhood experiences, and prevalence of mental disorders among the street homeless people in Seoul, Korea. In addition, we examined the associations between chronic homelessness and study variables.
Methods
The study subjects were 75 homeless people dwelling in the street around Seoul Station. Questionnaires related to socio-demographic data and the course of homelessness were provided to each subject. The subjects' Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) mental disorder diagnoses were made by using Mini International Neuropsychiatric Interview-Plus interviews.
Results
Most subjects exhibited chronic homelessness and the prevalence of DSM-IV mental disorders among the homeless subjects was higher than that among the Korean general population. There was a statistically significant association between chronic homelessness and adverse childhood experiences. Compared to those with no history of childhood adversity, homeless people with a history of childhood adversity had a younger age of first homeless episode and a higher prevalence of DSM-IV major mental disorders. The association between DSM-IV diagnosis and chronic homelessness was not significant, but the group with mental disorders had more prevalent re-housing and homeless recurrent histories.
Conclusion
Street homeless people were often involved in chronic homelessness. Results of this study suggest that homeless people who were never married and had adverse childhood experiences were more vulnerable to chronic homelessness. In addition, we detected a possible relationship between the recurrence of homelessness and the presence of mental disorders.
Figures and Tables
Table 1
Comparison of sociodemographic and clinical characteristics between chronic homeless and newly homeless group in 75 street homeless people
Table 4
Comparison of sociodemographic and clinical variables according to a history of childhood adversities
* : p<0.05, † : Independent t-test was used for continuous variables and Pearson's chi-square or Fisher's exact test was used for categorical variables. PHQ : Patient Health Questionnaire, DSM-IV : Diagnostic and Statistical Manual of Mental Disorders, fourth edition, GAD-7 : Generalized Anxiety Disorder 7-item Scale
References
1. Jung WO, Kim SH. A study on the profile of the new Korean homeless. Seoul Inst Res Stud. 1999; 7:69–90.
2. Lee TJ. A strarategic proposal of assistance programs for homeless in Korea. Health Welf Policy Forum. 2002; 73:6–18.
3. Auerswald CL, Lin JS, Parriott A. Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California. Peer J. 2016; 4:e1909.
4. Fazel S, Khosla V, Doll H, Geddes J. The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis. PLoS Med. 2008; 5:e225.
5. Lee MS, Hwang TY, Heo MS, Seo YJ, Lee SY. Comparative study of psychiatric symptom profiles between homeless people of street and shelter. J Korean Assoc Soc Psychiatry. 2006; 11:72–78.
6. Mohw.go.kr. Assistance policy for homeless. Ministry of Helth and Welfare;cited 2016 Sep 6. Available from: http://www.mohw.go.kr/front_new/index.jsp. [hompage on the Internet].
7. Korean Center for City and Environment Research. A study on rehousing support strategies and welfare for homeless. Seoul: Ministry of Welfare and Health;2012.
8. Kim MS. The current status of homeless in urban area and protection strategies. Health Welf Policy Forum. 1998; 20:27–38.
9. Grunberg J, Eagle PF. Shelterization: how the homeless adapt to shelter living. Hosp Community Psychiatry. 1990; 41:521–525.
10. Seoul Metropolitan Homeless Service Center. Annual report of Seoul Metropolitan Homeless Service Center. Seoul: Seoul Metropolitan Homeless Service Center;2015. p. 325–326.
11. Opengov.seoul.go.kr. The Seoul metropolitan government's department of sup-porting rehabilitation. Annual report on government service for reha-bilitation of homelss people. cited 2016 Sep 6. Available from: https://opengov.seoul.go.kr/public/5337189. [homepage on the internet].
12. Federalregister.gov. U.S Department of Housing and Urban Development. Notice of fund-ing availability (NOFA) for the Collaborative Initiative to Help End Chronic Homelessness. cited 2016 Sep 6. Availble from: https://www.federalregister.gov/. [homepage on the Internet].
13. Caton CL, Dominguez B, Schanzer B, Hasin DS, Shrout PE, Felix A, et al. Risk factors for long-term homelessness: findings from a longitudinal study of first-time homeless single adults. Am J Public Health. 2005; 95:1753–1759.
14. Piliavin I, Sosin M, Westerfelt AH, Matsueda RL. The duration of homeless careers: an exploratory study. Soc Serv Rev. 1993; 67:576–598.
15. Folsom DP, Hawthorne W, Lindamer L, Gilmer T, Bailey A, Golshan S, et al. Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. Am J Psychiatry. 2005; 162:370–376.
16. Hong JP, Park JI, Bang SY, Seo DW. Follw up study of residents of one homeless shelter in Korea. J Korean Assoc Soc Psychiatry. 2003; 8:152–156.
17. Stein JA, Leslie MB, Nyamathi A. Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood. Child Abuse Negl. 2002; 26:1011–1027.
18. Yu SW, Kim YS, Noh JS, Oh KS, Kim CH, Nam K, et al. Validity of Korean version of the Mini-International Neuropsychiatric Interview. Anxiety Mood. 2006; 2:50–55.
19. Kim SW, Stewart R, Kim JM, Shin IS, Yoon JS, Jung SW, et al. Relationship between a history of a suicide attempt and treatment outcomes in patients with depression. J Clin Psychopharmacol. 2011; 31:449–456.
20. Kim SW, Kang HJ, Kim SY, Kim JM, Yoon JS, Jung SW, et al. Impact of childhood adversity on the course and suicidality of depressive disorders: the CRESCEND study. Depress Anxiety. 2013; 30:965–974.
21. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16:606–613.
22. Park SJ, Choi HR, Choi JH, Kim KW, Hong JP. Reliability and Validity of the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Anxiety Mood. 2010; 6:119–124.
23. Han C, Pae CU, Patkar AA, Masand PS, Kim KW, Joe SH, et al. Psychometric properties of the Patient Health Questionnaire-15 (PHQ-15) for measuring the somatic symptoms of psychiatric outpatients. Psychosomatics. 2009; 50:580–585.
24. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166:1092–1097.
25. Mohw.go.kr. The epidemiological survey of mental disorder in Korea. Ministry of Health and Welfare;cited 2016 Sep 6. Available from: http://www.mohw.go.kr/front_new/index.jsp. [homepage on the Internet].
26. Han OS, Hong JP, Ha JH, Lee C, Kim CY, Lee DW, et al. Prevalence of mental disorder and quality of life among the homeless people in a city shelter. J Korean Neuropsychiatr Assoc. 2001; 40:804–812.
27. Hahm BJ, Lee DW, Lee JH, Choi YM, Kim BS, Hong SH, et al. Prevalence of psychiatric disorders in male homeless. J Korean Neuropsychiatr Assoc. 2003; 42:644–653.
28. Ahn JH, Hong JP, Yu JC, Park JI, Lee C, Han OS. Epidemiologic study on mental disorders in urban homeless people. J Korean Neuropsychiatr Assoc. 2001; 40:193–202.
29. Sheehan DV, Lecrubier Y, Harnett Sheehan K, Janavs J, Weiller E, Keskiner A, et al. The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry. 1997; 12:232–241.
30. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998; 59:Suppl 20. 22–33. quiz 34-57.
31. North CS, Pollio DE, Thompson SJ, Ricci DA, Smith EM, Spitznagel EL. A comparison of clinical and structured interview diagnoses in a homeless mental health clinic. Community Ment Health J. 1997; 33:531–543.
32. Korean Center for City and Environment Research. Annual survey report on homeless people in Seoul 2014. Seoul: Korean Center for City and Environment Research;2014. p. 34–36.
33. Shelton KH, Taylor PJ, Bonner A, van den Bree M. Risk factors for homelessness: evidence from a population-based study. Psychiatr Serv. 2009; 60:465–472.
34. Sundin EC, Baguley T. Prevalence of childhood abuse among people who are homeless in Western countries: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2015; 50:183–194.
35. Torchalla I, Strehlau V, Li K, Schuetz C, Krausz M. The association between childhood maltreatment subtypes and current suicide risk among homeless men and women. Child Maltreat. 2012; 17:132–143.
36. Susser E, Valencia E, Conover S, Felix A, Tsai WY, Wyatt RJ. Preventing recurrent homelessness among mentally ill men: a “critical time” intervention after discharge from a shelter. Am J Public Health. 1997; 87:256–262.
XML Download