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Homelessness and Neuropsychological Impairment: Preliminary Analysis of Adults Entering Outpatient Psychiatric Treatment

Bousman, Chad A. MPH, PhD*; Twamley, Elizabeth W. PhD; Vella, Lea MPH; Gale, Maiken PhD; Norman, Sonya B. PhD; Judd, Patricia PhD; Everall, Ian P. MB ChB (Hons), PhD, FRCPath, FRCPsych, FRANZP*; Heaton, Robert K. PhD

The Journal of Nervous and Mental Disease: November 2010 - Volume 198 - Issue 11 - p 790-794
doi: 10.1097/NMD.0b013e3181f97dff
Original Articles

Homelessness has been associated with neuropsychological (NP) impairment, but few studies have adequately controlled for factors known to affect NP performance. We performed brief NP testing examining learning, recall, processing speed, executive functioning, and verbal fluency in 50 ever- and 22 never-homeless persons entering outpatient psychiatric treatment. Groups were matched a priori on key demographic, substance use, psychiatric, and premorbid intelligenc quotient characteristics. Rates of NP impairment were high among both groups (46%–54%). There were no significant differences in global NP impairment. There were trends toward better levels of processing speed and executive functioning among never-homeless relative to ever-homeless. Among the ever-homeless group, NP test performance was unrelated to number of homelessness episodes (median 3). Findings confirm high prevalence of NP impairment among homeless individuals but provide little evidence for broad NP differences between ever- and never-homeless persons matched for coexisting conditions that have confounded interpretation of previous results in the literature.

*Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia; and †Department of Psychiatry, University of California San Diego, La Jolla, CA.

Send reprint requests to Chad A. Bousman, MPH, PhD, Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Level 1, Melbourne, VIC 3050, Australia. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.