Child abuse, psychiatric symptoms predict future homelessness

Psychiatric symptoms earlier in life among individuals with a recorded history of childhood maltreatment appear to increase the risk of homelessness, which is considered a serious and increasing public health concern, suggests a recent study. 

The analysis used data from a prospective cohort study that followed individuals with documented histories of childhood maltreatment (ages 0–11 years) and a demographically matched group of children without such histories (n=1,196) into middle adulthood. 

The authors assessed psychiatric symptoms (eg, anxiety, depression, post-traumatic stress disorder [PTSD], antisocial personality disorder [ASPD], and alcohol and drug use) in participants at a mean age of 29 years. They also assessed homelessness at the mean ages of 29, 39, 41, and 47 years. Mediation was examined using a structural equation modelling. 

Individuals with a history of childhood maltreatment were twice as likely to report ever being homeless (25.6 percent vs 12.3 percent; adjusted odds ratio [aOR], 2.54, 95 percent confidence interval [CI], 1.86–3.50) and past year homelessness (5.5 percent vs 2.5 percent; aOR, 2.09, 95 percent CI, 1.31–3.43) at age 29 years compared with control participants. 

When controlling for past homelessness, the authors found that psychiatric symptoms were predictive of future homelessness at mean ages of 41 and 47 years. They also identified three significant paths from childhood maltreatment to future homelessness through depression, PTSD, and ASPD. 

“Depression, PTSD, and ASPD represent pathways through which childhood maltreatment increases homelessness risk and warrant greater attention,” the authors said.