Childhood Adversities Associated with Poor Adult Mental Health Outcomes in Older Homeless Adults: Results From the HOPE HOME Study

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• 作者：Chuan Mei Lee ; M.D. ; M.A.^a ; ^{ChuanMei.Lee@ucsf.edu} ; Christina Mangurian ; M.D. ; M.A.S.^a ; ^b ; Lina Tieu ; M.P.H.^b ; ^c ; Claudia Ponath ; M.A.^c ; David Guzman ; M.S.P.H.^b ; ^c ; Margot Kushel ; M.D.^b ; ^c
• 关键词：geriatrics ; homeless persons ; depression ; suicide ; mental health services ; epidemiology
• 刊名：The American Journal of Geriatric Psychiatry
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：25
• 期：2
• 页码：107-117
• 全文大小：387 K
• 卷排序：25

文摘

To examine whether childhood adversity is associated with depressive symptoms, suicide attempts, or psychiatric hospitalization.MethodsHistory of seven childhood adversities (physical neglect, verbal abuse, physical abuse, sexual abuse, parental death, parental incarceration, and child welfare system placement) was gathered through in-person interviews. Multivariate models examined associations between history of childhood adversities and moderate to severe depressive symptoms, lifetime history of suicide attempt, or lifetime history of psychiatric hospitalization. The study enrolled 350 homeless adults, aged 50 and older, in Oakland, California, using population-based sampling methods. Moderate to severe depressive symptoms were measured on a Center for Epidemiologic Studies–Depression Scale (≥22), self-reported lifetime history of suicide attempt, and self-reported lifetime history of psychiatric hospitalization.ResultsParticipants with exposure to one childhood adversity had elevated odds of reporting moderate to severe depressive symptoms (adjusted odds ratio [AOR]: 2.0; 95% confidence interval [CI]: 1.1–3.7) and lifetime history of suicide attempt (AOR: 4.6; 95% CI: 1.0–21.6) when compared with those who had none; the odds of these two outcomes increased with exposure to additional childhood adversities. Participants with four or more childhood adversities had higher odds of having a lifetime history of psychiatric hospitalization (AOR: 7.1; 95% CI: 2.8–18.0); no increase with fewer adversities was found.ConclusionChildhood adversities are associated with poor mental health outcomes among older homeless adults. Clinicians should collect information about childhood adversities among this high-risk population to inform risk assessment and treatment recommendations.