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Risk of homelessness after discharge from psychiatric wards in Denmark: A Nationwide Register-Based Cohort Study

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DOI

  • Sandra Feodor Nilsson, iPSYCH The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Denmark, Copenhagen University
  • ,
  • Thomas Munk Laursen
  • Carsten Hjorthøj, Section of Epidemiology, Department of Public Health, The University of Copenhagen, Copenhagen, Denmark, iPSYCH, Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Lundbeck Fdn Initiat Integrat Psychiat Res
  • ,
  • Merete Nordentoft, l Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark., iPSYCH, Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Lundbeck Fdn Initiat Integrat Psychiat Res

OBJECTIVE: To examine the absolute and relative risk of homelessness following discharge from psychiatric wards in Denmark.

METHODS: A nationwide, register-based, cohort study including people aged 18+ years discharged from psychiatric wards in Denmark between Jan 1, 2001 and Dec 31, 2015. We analysed associations between psychiatric diagnoses and risk of homelessness using survival analysis.

RESULTS: 126,848 psychiatric inpatients were included accounting for 94,835 person-years. The incidence of homelessness one year following discharge was 28.18 (95% CI 26.69-29.75) and 9.27 (95% CI 8.45-10.16) per 1000 person-years at risk in men and women, respectively. The one-year cumulative probability of first homelessness after discharge from psychiatric wards was 1.58% (95% CI 1.48-1.68) in males and 0.55% (95% CI 0.50-0.61) in females. Substance use disorders increased the risk of homelessness after discharge with adjusted incidence rate ratios of 6.60 (95% CI 5.19-8.40) (men) and 13.06 (95% CI 9.31-18.33) (women), compared with depressive disorders. Prior history of homelessness was an important predictor for homelessness following discharge.

CONCLUSIONS: The first year following discharge from psychiatric wards is a high-risk period of homelessness, especially when having a substance use disorder or a prior history of homeless shelter contact. Improved efforts to prevent homelessness are needed. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalActa Psychiatrica Scandinavica
Volume140
Issue5
Pages (from-to)477-489
Number of pages13
ISSN0001-690X
DOIs
Publication statusPublished - Nov 2019

    Research areas

  • epidemiology, homelessness, psychiatric discharge

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