Neuropsychological Function in Homeless Mentally Ill Individuals

Abstract

Because little data are available on the neuropsychological functioning of severely and persistently mentally ill (SPMI) persons who are homeless, our primary goal was to describe accurately and extensively the general neuropsychological functioning of a large group of such homeless individuals. In addition, we have sought to examine the relationship between some neuropsychological functions and demographic, illness, and clinical state measures in this population. A 5-hour neuropsychological test battery was administered to 116 SPMI homeless individuals. Neuropsychological, diagnostic, substance abuse, clinical, and psychopathology data were obtained in a standardized manner. SPMI homeless individuals were significantly impaired on a wide range of neuropsychological functions. Specific test performances were most significantly related to precursor variables (level of education and parental socioeconomic status) and state variables (level of psychosis and anticholinergic medication dose). Gender and substance abuse had significant effects limited to sustained attention. Neuropsychological performance was impaired in this sample of homeless SPMI persons. Further research, using profile analysis to directly compare groups composed of homeless persons without psychiatric illness or demographically matched persons of comparable psychiatric status who are not homeless will help clarify the role of homelessness and psychosis on neuropsychological function.

Memory impairment among people who are homeless: A systematic review

“…The critical appraisal ratings for included articles ranged between 1 (Medalia, Herlands, & Baginsky, 2003) and 7 (Seidman et al, 1997), and half of the studies were of poor or fair quality (Table 1). The majority of studies received low scores due to small sample sizes, low response rates and biased measurements or non-blinding where applicable.…”

“…Four of the included studies (Caplan et al, 2006;Schutt et al, 2007;Seidman et al, 1997;Seidman et al, 2003) were part of the Boston McKinney Project, designed to test the effects of housing on the neuropsychological functioning of severely and persistently mentally ill homeless persons in Boston. In the other studies, unique samples of homeless persons were assessed (Andersen et al, 2014;Bousman et al, 2010;Cotman & Sandman, 1997;Medalia et al, 2003;Pluck, Kwang-Hyuk, David, Spence, & Parks, 2012;Solliday-McRoy et al, 2004;Stergiopoulos, Burra, Rourke, & Hwang, 2011).…”

“…In total, memory impairment was assessed across eight unique samples of persons who were homeless. The size of the samples ranged between 12 (Medalia et al, 2003) and 116 (Seidman et al, 1997). A total of 436 individuals who were homeless were assessed for memory difficulties.…”

“…Neuropsychological measures assessing verbal memory were used in nine studies (Andersen et al, 2014;Bousman et al, 2010;Caplan et al, 2006;Cotman & Sandman, 1997;Schutt et al, 2007;Seidman et al, 1997;Seidman et al, 2003;Solliday-McRoy et al, 2004;Stergiopoulos et al, 2011). The most commonly used measure, the Wechsler Memory Scale (WMS), assessed learning, immediate and delayed recall as well as recognition (Wechsler, 1997(Wechsler, , 2002.…”

Housing Satisfaction Among Chronically Homeless Adults: Identification of its Major Domains, Changes Over Time, and Relation to Subjective Well-being and Functional Outcomes

“…Chronically homeless adults make frequent transitions in and out of homelessness, and between housing settings. Researchers have identified many factors related to housing tenure, including demographics (Cook 1994;Lipton et al 2000), substance abuse problems (Drake et al 1991;Schutt and Goldfinger 1996), clinical and neuropsychological functioning (Folsom et al 2005;Seidman et al 1997), rent subsidies (Rosenheck et al 2003), and the type and quality of housing (Goldfinger et al 1999;Tsai et al 2010a). However, housing satisfaction and its relation to housing tenure has not been adequately studied (Tsemberis et al 2003).…”