The hotel study: multimorbidity in a community sample living in marginal housing.
Am J Psychiatry
; 170(12): 1413-22, 2013 Dec.
Article
en En
| MEDLINE
| ID: mdl-23929175
ABSTRACT
OBJECTIVE:
The health of people living in marginal housing is not well characterized, particularly from the perspective of multimorbid illness. The authors investigated this population in a community sample.METHOD:
A prospective community sample (N=293) of adults living in single-room occupancy hotels was followed for a median of 23.7 months. Assessment included psychiatric and neurological evaluation, multimodal MRI, and viral testing.RESULTS:
Previous homelessness was described in 66.6% of participants. Fifteen deaths occurred during 552 person-years of follow-up. The standardized mortality ratio was 4.83 (95% CI=2.91-8.01). Substance dependence was ubiquitous (95.2%), with 61.7% injection drug use. Psychosis was the most common mental illness (47.4%). A neurological disorder was present in 45.8% of participants, with definite MRI findings in 28.0%. HIV serology was positive in 18.4% of participants, and hepatitis C virus serology in 70.3%. The median number of multimorbid illnesses (from a list of 12) was three. Burden of multimorbidity was significantly correlated with lower role functioning score. Comorbid addiction or physical illness significantly decreased the likelihood of treatment for psychosis but not the likelihood of treatment for opioid dependence or HIV disease. Participants who died during follow-up appeared to have profiles of multimorbidity similar to those of the overall sample.CONCLUSIONS:
This marginally housed cohort had greater than expected mortality and high levels of multimorbidity with adverse associations with role function and likelihood of treatment for psychosis. These findings may guide the development of effective health care delivery in the setting of marginal housing.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Trastornos Psicóticos
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Trastornos Relacionados con Sustancias
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Vivienda
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Enfermedades del Sistema Nervioso
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
País como asunto:
America do norte
Idioma:
En
Año:
2013
Tipo del documento:
Article