Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems.

BackgroundWhile the prevalence of mental illness or cognitive disability is higher among homeless people than the general population in Western countries, few studies have investigated its prevalence in Japan or other Asian countries. The present study conducted a survey to comprehensively assess prevalence of mental illness, cognitive disability, and their overlap among homeless individuals living in Nagoya, Japan.MethodsParticipants were 114 homeless individuals. Mental illness was diagnosed based on semi-structured interviews conducted by psychiatrists. The Wechsler Adult Intelligence Scale-III (WAIS-III, simplified version) was used to diagnose intellectual/ cognitive disability.ResultsAmong all participants, 42.1% (95% CI 33.4–51.3%) were diagnosed with a mental illness: 4.4% (95% CI 1.9–9.9%) with schizophrenia or other psychotic disorder, 17.5% (95% CI 11.6–25.6%) with a mood disorder, 2.6% (95% CI 0.9–7.5%) with an anxiety disorder, 14.0% (95% CI 8.8–21.6%) with a substance-related disorder, and 3.5% (95% CI 1.4–8.8%) with a personality disorder. Additionally, 34.2% (95% CI 26.1–43.3%) demonstrated cognitive disability: 20.2% (95% CI 13.8–28.5%) had mild and 14.0% (95% CI 8.8–21.6%) had moderate or severe disability. The percent overlap between mental illness and cognitive disability was 15.8% (95% CI 10.2–23.6%). Only 39.5% (95% CI 26.1–43.3%) of the participants were considered to have no psychological or cognitive dysfunction. Participants were divided into four groups based on the presence or absence of mental illness and/or cognitive disability. Only individuals with a cognitive disability reported a significant tendency toward not wanting to leave their homeless life.ConclusionThis is the first report showing that the prevalence of mental illness and/or cognitive disability among homeless individuals is much higher than in the general Japanese population. Appropriate support strategies should be devised and executed based on the specificities of an individual’s psychological and cognitive condition.

Aim:While it has been reported that the prevalence of mental illness is higher in homeless people than in the national population, few studies have investigated the prevalence of intellectual and developmental disability among the homeless. In this study, we conducted a survey to comprehensively assess these mental problems among homeless people in Nagoya, Japan. Methods:The subjects were 18 homeless men. Mental illness was diagnosed with semi-structured interviews conducted by psychiatrists. We used the Wechsler Adult Intelligence Scale III to diagnose intellectual disability. Discrepancies between Wechsler Adult Intelligence Scale III subtest scores were used as criteria for developmental disability.Results: Eleven of the 18 participants were diagnosed with mental illness: six with mood disorder, two with psychotic disorder, and six with alcohol problems. The mean IQ of all subjects was 83.4 ± 27.4. The 95% confidence interval (CI) was 96.2-69.1. Seven participants were found to have intellectual disability. Three men showed discrepancies of more than 10 between subtest scores, and all of them were diagnosed with a mental illness. We divided the participants into four groups: those with mental illness only; those with intellectual disability only; those with both problems; and those without diagnosis. The men with intellectual disability only were significantly younger and had been homeless since a younger age than the other groups. Participants diagnosed with a mental illness had been homeless for longer than those without mental health problems. Conclusion:Although the sample size was limited, this study revealed the high prevalence of mental illness and intellectual disability, 61% (95%CI, 35-83%) and 39% (95%CI, 17-64%), respectively, in homeless people in Nagoya, Japan.

Aims/Introduction The diabetes status of homeless people has not been elucidated because of the limited access to this population. We carried out a survey of the prevalence of diabetes and prediabetes among homeless men in Nagoya, Japan, and assessed the associations between diabetes prevalence and sociodemographic characteristics. Materials and Methods Interviews relating to individuals’ sociodemographic background, mental illness and cognitive ability, and blood sampling were carried out for 106 homeless men (mean age 54.2 ± 12.7 years). Diabetes, prediabetes and normoglycemia were diagnosed according to the individual's hemoglobin A1c level: ≥6.5%, 6.4–6.0% and ≤5.9%, respectively. Mental illness and cognitive disability were diagnosed using the Mini‐International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale‐ III , respectively. Associations between the prevalence of diabetes/prediabetes and mental illness/cognitive disability or sociodemographic background were analyzed using the χ 2 ‐test. Results Seven (6.6%) and 12 (11.3%) participants were diagnosed as having diabetes and prediabetes, respectively, which was a similar trend to that of general populations in Japan National Health and Nutrition Survey data. There was a significant difference in the prediabetes prevalence between groups with and without a history of having social support; however, no significant associations were found between the diabetes/prediabetes prevalence and mental illness/cognitive ability or participants’ sociodemographic background. Conclusions The incidence of diabetes in Japanese homeless men was similar to that in the general population, and the prediabetes incidence was lower in the group with social support than in that without. Early intervention for preventing diabetes and social support that focuses on diabetes management is important for homeless people.

Background There are few reports that objectively show actual health conditions among the homeless or diagnoses of non-communicable diseases based on blood tests. This report discloses the actual data from blood tests and non-communicable diseases among the participants. Furthermore, associations between the test values for lifestyle-related disease and mental disorder/intellectual disability, as well as personal backgrounds of homeless people, were analyzed from the data gathered in the survey. Methods This study was performed in a rented meeting room close to Nagoya Station on November 2, 2014. Blood samples, physical measurements, blood pressure measurements intellectual faculties were measured. Physical/mental diseases were diagnosed by doctors. Fisher’s exact test was performed to compare between subgroups (by participants’ socio-demographic data or the presence of mental illness/cognitive disability) according to non-communicable disease test values, and to calculate the odds ratio. Results Abnormalities among participants in test values for non-communicable disease were as follows: hypoalbuminemia in one participant (0.9%), abnormalities in liver function in 22 participants (19.3%), decreased renal function in two participants (1.8%), dyslipidemia in 67 participants (58.8%), "a person whose impaired glucose tolerance cannot be ruled out" in 20 participants (17.5%), obesity in 33 participants (28.9%), thinness in five participants (4.3%), and hypertension in 60 participants (52.6%). Compared to the National health and nutrition survey 2015, non-communicable diseases of the homeless people were similar or slightly better than in the general population in Japan. Participants aged 20–39 years had a significant positive tendency of having liver function abnormality compared to ≥60 years old participants. There was no significant tendency with socio-demographic characteristics in dyslipidemia and “impaired glucose tolerance”. Conclusion It was found that the percentage of homeless people in Nagoya who showed abnormalities of lifestyle-related disease was similar or better than that of general population in Japan.