Esquizofrenia e a condição de sem-abrigo

• Autor(a) principal: Luís Carlos Pinto dos Santos Pissarra Moutinho
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/128796
• topic: Medicina clínica; Clinical medicine

Introduction: Schizophrenia is a severe, disabling and chronic psychotic disorder. Many patients live on the streets, without any medical or social support. Our aim was to assess how schizophrenia and homelessness are socioeconomically impacted, briefly characterize the homeless' mental health, namely the relationships between their condition and schizophrenia, and assess some health and social interventions for schizophrenia patients who are homeless. Materials and Methods: We reviewed 36 articles in PubMed using the following keywords: schizophrenia; schizophrenia spectrum and other psychotic disorders; psychotic disorders; homeless persons; homeless youth, as well as 10 additional references. Results: In schizophrenia, genetic risk factors interact with social and economic factors of "social defeat", such as having a low socioeconomic status and belonging to a small and isolated immigrant community. Income inequalities, urbanization, incarceration, precocious exposure to violence and "social defeat" foster homelessness. All mental illnesses are more prevalent in the homeless. Psychotic disorders precede the deterioration of the individual's socioeconomic conditions. Schizophrenia and homelessness have mutual detrimental effects, and both are worsened by urbanicity. "Urban remediation" may attenuate urban-related psychosis. Discussion: Housing, economic and health support of poor households prevents homelessness. Promotion and prevention programs include Mental Health in the reduction of inequalities and the promotion of recovery and integration of the homeless. Homeless people with psychotic disorders benefit from integrated interventions addressing both their health and social needs. Stable housing is essential to the effective treatment of severe mental illnesses, Housing First providing higher therapeutic adherence, housing stability and continuity of care, and reduced psychiatric admissions, as well as better cost-effectiveness.