거리노숙인의 만성노숙과 연관된 인구사회학적, 임상적 변인
Socio-Demographic and Clinical Variables Associated with Chronic Homelessness among the Street Homeless People
0
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
ObjectivesZZThis 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. MethodsZZThe 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. ResultsZZMost 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. ConclusionZZStreet 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.
Abstract
ObjectivesZZThis 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. MethodsZZThe 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. ResultsZZMost 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. ConclusionZZStreet 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.
참고문헌 (36)
- Jung WO, "A study on the profile of the new Korean homeless", Seoul Inst Res Stud, 7, pp.69~90 (1999)
- Lee TJ, "A strarategic proposal of assistance programs for homeless in Korea", Health Welf Policy Forum, 73, pp.6~18 (2002)
- Auerswald CL, "Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California", Peer J, 4, pp.e1909~ (2016)
- Fazel S, "The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis", PLoS Med, 5, pp.e225~ (2008)
- Lee MS, "Comparative study of psychiatric symptom profiles between homeless people of street and shelter", J Korean Assoc Soc Psychiatry, 11, pp.72~78 (2006)
- "Ministry of Helth and Welfare. Assistance policy for homeless"[URL]
- A study on rehousing support strategies and welfare for homeless, "Korean Center for City and Environment Research", Ministry of Welfare and Health, ~ (2012)
- Kim MS, "The current status of homeless in urban area and protection strategies", Health Welf Policy Forum, 20, pp.27~38 (1998)
- Grunberg J, "Shelterization: how the homeless adapt to shelter living", Hosp Community Psychiatry, 41, pp.521~525 (1990)
- Annual report of Seoul Metropolitan Homeless Service Center, "Seoul Metropolitan Homeless Service Center", Seoul Metropolitan Homeless Service Center, 325~326 (2015)
- "The Seoul metropolitan government’s department of sup-porting rehabilitation. Annual report on government service for reha-bilitation of homelss people"[URL]
- "U.S Department of Housing and Urban Development. Notice of fund-ing availability (NOFA) for the Collaborative Initiative to Help End Chronic Homelessness"[URL]
- Caton CL, "Risk factors for long-term homelessness: findings from a longitudinal study of first-time homeless single adults", Am J Public Health, 95, pp.1753~1759 (2005)
- Piliavin I, "The duration of homeless careers: an exploratory study", Soc Serv Rev, 67, pp.576~598 (1993)
- Folsom DP, "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, 162, pp.370~376 (2005)
- Hong JP, "Follw up study of residents of one homeless shelter in Korea", J Korean Assoc Soc Psychiatry, 8, pp.152~156 (2003)
- Stein JA, "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, 26, pp.1011~1027 (2002)
- Yu SW, "Validity of Korean version of the Mini-International Neuropsychiatric Interview", Anxiety Mood, 2, pp.50~55 (2006)
- Kim SW, "Relationship between a history of a suicide attempt and treatment outcomes in patients with depression", J Clin Psychopharmacol, 31, pp.449~456 (2011)
- Kim SW, "Impact of childhood adversity on the course and suicidality of depressive disorders: the CRESCEND study", Depress Anxiety, 30, pp.965~974 (2013)
- Kroenke K, "The PHQ-9: validity of a brief depression severity measure", J Gen Intern Med, 16, pp.606~613 (2001)
- 박승진, "한글판 우울증 선별도구(Patient Health Questionnaire-9, PHQ-9)의 신뢰도와 타당도", 대한불안의학회지, 6(2), pp.119~124 (2010), 대한불안의학회
- Han C, "Psychometric properties of the Patient Health Questionnaire-15 (PHQ-15)for measuring the somatic symptoms of psychiatric outpatients", Psychosomatics, 50, pp.580~585 (2009)
- Spitzer RL, "A brief measure for assessing generalized anxiety disorder: the GAD-7", Arch Intern Med, 166, pp.1092~1097 (2006)
- "Ministry of Health and Welfare. The epidemiological survey of mental disorder in Korea"[URL]
- 한오수, "도시 쉼터 노숙자의 정신장애 유병율과 삶의 질", 신경정신의학, 40(5), pp.804~812 (2001), 대한신경정신의학회
- 함봉진, "노숙 시설을 이용하는 남자 노숙자에서 정신장애의 유병율", 신경정신의학, 42(5) (2003), 대한신경정신의학회
- 안준호, "도시 노숙자의 주요 정신장애에 관한 역학 연구", 신경정신의학, 40(2), pp.193~202 (2001), 대한신경정신의학회
- Sheehan DV, "The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability", Eur Psychiatry, 12, pp.232~241 (1997)
- Sheehan DV, "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, 59(Suppl 20), pp.22~33 (1998)
- North CS, "A comparison of clinical and structured interview diagnoses in a homeless mental health clinic", Community Ment Health J, 33, pp.531~543 (1997)
- Korean Center for City and Environment Research, "Annual survey report on homeless people in Seoul 2014", pp.34~36 (2014), Korean Center for City and Environment Research
- Shelton KH, "Risk factors for homelessness: evidence from a population-based study", Psychiatr Serv, 60, pp.465~472 (2009)
- Sundin EC, "Prevalence of childhood abuse among people who are homeless in Western countries: a systematic review and meta-analysis", Soc Psychiatry Psychiatr Epidemiol, 50, pp.183~194 (2015)
- Torchalla I, "The association between childhood maltreatment subtypes and current suicide risk among homeless men and women", Child Maltreat, 17, pp.132~143 (2012)
- Susser E, "Preventing recurrent homelessness among mentally ill men: a “critical time” intervention after discharge from a shelter", Am J Public Health, 87, pp.256~262 (1997)
