The high burden of traumatic brain injury and comorbidities amongst homeless adults with mental illness. (April 2017)

• Record Type: Journal Article
• Authors: Topolovec-Vranic, Jane; Schuler, Andree; Gozdzik, Agnes; Somers, Julian; Bourque, Paul-Émile; Frankish, C. James; Jbilou, Jalila; Pakzad, Sarah; Palma Lazgare, Luis Ivan; Hwang, Stephen W.
• Is Part Of: Journal of psychiatric research. Volume 87(2017)
• Page Start: 53
• Page End: 60
• Publication Date: 2017-04
• Subjects: Brain injuries -- Homeless persons -- Mental disorders -- Psychiatric diagnosis -- Health care delivery -- Comorbidity; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2016.12.004
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: Objective: characterize the prevalence of self-reported head injury with loss of consciousness (LOC) and associated demographic, clinical and service use factors in a sample of homeless adults with mental illness. Method: Participants in the At Home/Chez Soi study were interviewed at the time of study enrollment regarding their history of head injuries, mental and physical health diagnoses and justice system and healthcare interactions. Sociodemographic and clinical data were also collected. Results: Over half of the 2088 study respondents (52.6%, n = 1098) reported a history of head injury with a LOC, which was associated with several demographic, clinical and service use variables in this population. With respect to specific mental health conditions, a history of head injury with LOC was associated with higher odds of current depression (OR = 2.18, CI: 1.83–2.60), manic episode or hypomanic episode (OR = 1.91, CI: 1.45–2.50), PTSD (OR = 2.98, CI: 2.44–3.65), panic disorder (OR = 2.37, CI:1.91–2.93), mood disorder (OR = 1.78, CI: 1.40–2.26) and alcohol (OR = 2.09, CI: 1.75–2.49) and drug (OR = 1.73, CI: 1.46–2.06) misuse disorders, but reduced odds of having diagnosis of a psychotic disorder (OR = 0.63, CI: 0.53–0.76). A history of head injury with LOC was also associated with increased use of variety of services, including family medicine (OR = 1.33, CI: 1.12–1.59), criminal justice system (OR = 1.50, CI: 1.25–1.80) and the emergency department (OR = 1.03, CI: 1.01–1.05). Conclusions: Amongst homeless adults with mental illness having a history of head injuries with LOC was independently associated with various adverse outcomes. These individuals constitute a high-risk group who may benefit from specialized services.