Psychiatric, Substance Abuse Disorders Common in Homeless

Increased mortality risk in Danish homeless people with registered substance abuse disorders

WEDNESDAY, June 15 (HealthDay News) -- A high proportion of homeless people in Denmark have psychiatric disorders and/or a substance abuse diagnosis, which is associated with increased mortality, according to a study published online June 14 in The Lancet.

Sandra Feodor Nielsen, from the University of Copenhagen in Denmark, and colleagues assessed registered psychiatric disorders, mortality, and predictors of mortality in 32,711 homeless people (23,040 men and 9,671 women) registered in the Danish homeless register from 1999 to 2009. The participants were assessed for proportion of registered psychiatric disorders, overall and cause-specific standardized mortality ratio (SMR), and life expectancy.

The investigators found that, of the total homeless cohort, 14,381 (62.4 percent) men and 5,632 (58.2 percent) women had registered psychiatric disorders, and 11,286 (49.0 percent) men and 3,564 (36.9 percent) women had a diagnosis of substance abuse. A total of 3,839 (16.7 percent) men and 951 (9.8 percent) women died during the study period. The overall SMR was 5.6 and 6.7 for men and women, respectively. A total of 1,161 (27.9 percent) deaths were accounted for by external causes for which information was available. Compared to the general population, the remaining life expectancy at age 15 to 24 years was 21.6 and 17.4 years lower for men and women, respectively. Higher mortality risk was associated with registered substance abuse disorder (adjusted hazard ratio, 1.4 and 1.7 for men and women, respectively), compared to participants with no psychiatric contact.

"Health problems are extensive in the homeless shelter population and there is an urgent need for more sustained efforts to reduce the high morbidity and mortality, especially from external causes," the authors write.

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