Aim: the Samenta study, based on a random sample of users of homeless services in the Paris area, aims at providing estimates of psychiatric disorder pr evalence care. Methods: interviews were made through emergency services (day services, emergency shelters, hot meals distribution), long term rehabilitation centres, and social hotels. Following a pilot study to test the diagnosis procedure, social and clinical information were collected by a lay interviewer, using the Mini International Neuropsychiatric Interview, in the presence of a psychologist who completed with an open clinical interview. In case of clinical signs, the psychologist reported to a psychiatrist who assessed the presence or absence of psychiatric diagnosis according to ICD10. The survey took place in winter 2009. Eight hundred and fifty nine homeless aged 18 or above participated (participation rate: 71%). Results: about one-third had at least one severe psychiatric disorder. Psychotic disorders were found in 13.2% including schizophrenia in 8.4%. Psychotic disorders were more frequent in males (15.4%) than in females (9.1%), in individuals born in France (21.6%) than in immigrants (7.5%) and in emergency (19%) than in other services (<10%). Severe mood disorders were diagnosed in 6.7% without difference between males and females. Anxiety disorders were found in 12.2% (7.5% males vs. 21% females), PTSD was more frequent in immigrants (6.2% vs. 1.1%) while GAD more frequent in natives (8.3% vs. 1.1%). One in five was alcohol dependent: 26.7 % in emergency compared to long term (18.9 %) or social hotels (5.5 %). Conclusion: high rates of severe psychiatric disorders, particularly psychosis, were found among homeless population. The most severe disorders were encountered in emergency services. These results advocate for prevention of social exclusion of people with severe psychiatric disorders and for improvement in detection and services for psychiatric disorders in homeless population but also for housing policies.
Auteur : Chan Chee C, Douay C, Detrez MA, Le Masson V, Le Strat Y, Chauvin P, Laporte A, SAMENTA research group
Année de publication : 2010
Pages : 24 p.