Challenges identified for homeless people with schizoaffective disorder

The difficulties in defining schizoaffective disorder, as well as complications associated with managing homeless patients, result in considerable challenges for homeless people with schizoaffective disorder, according to research published online Nov. 1 in the International Journal of Social Psychiatry.

Alexandre Spranger Forte, from the Universidade de Lisboa in Portugal, and colleagues conducted a literature review to examine the potential association between schizoaffective psychosis and being homeless. Data were included from 28 articles.

The researchers note that the homeless population suffers from considerable diagnostic variability and the diagnosis of schizoaffective psychosis is evolving. Both of these issues contribute to difficulties in diagnosis and treatment. The frequent visits to health care services, especially the emergency department, lead to interaction with multiple health care professionals, resulting in multiple diagnoses, without attainment of clinical remission or therapeutic goals.

"The homeless population with schizoaffective disorder, undergoing psychiatric treatment, is a particularly difficult population to follow. Compliance with outpatient visits and medication is still a challenge," the authors write. "Homeless people with schizoaffective disorder must contend with competing priorities, such as securing food and shelter. This frequently takes precedence over health care. They may also avoid care due to a lack of trust of the health care system and previous experiences of discrimination from providers."

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