Addressing the complex needs of homeless youth with early psychosis and comorbid substance use: a naturalistic longitudinal study of 10 years' experience with EQIIP SOL's specialized outreach service.

IF 3.6 2区医学 Q1 PSYCHIATRY

Social Psychiatry and Psychiatric Epidemiology Pub Date : 2025-04-21 DOI:10.1007/s00127-025-02875-7

Beatrice Todesco, Paula Pires De Oliveira Padilha, Daniel Rabouin, Clairélaine Ouellet-Plamondon, Didier Jutras-Aswad, Amal Abdel-Baki

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引用次数: 0

Abstract

Purpose: Psychosis and substance use disorders (SUDs) are highly prevalent and often co-occurring among homeless youth. EQIIP SOL, a specialized intensive outreach program within an early intervention service, provides 3-year comprehensive care for first-episode psychosis (FEP) homeless youth, targeting psychosis, SUD, and homelessness. This study aims to examine clinical and functional outcomes, along with predictors of housing stability, among youth enrolled in the program since its inception in 2012.

Methods: This longitudinal study examined the 3-year outcomes of all youth admitted to EQIIP SOL from 2012 to 2020. The inclusion criteria encompassed youth aged 18-30 years, diagnosed with primary psychosis and SUD and experiencing homelessness. Assessments were conducted at baseline and at 1, 3, 6, 9, 12, 15, 18, 24, and 36 months thereafter to describe housing stability, illness severity, and general functioning evolutions. Alcohol and substance use were evaluated at baseline and annually. A multivariate mixed-effects model investigated baseline predictors of housing stability.

Results: Of the 177 enrolled youth, 81.4% achieved housing stability at least once, within a median of six months. Improvements in illness severity and general functioning were observed during the initial nine months, plateauing thereafter. SUDs reduced approximately by one-third; alcohol use disorder decreased by half. Older age (OR = 1.18 (1.07-1.31)), no history of chronic homelessness (OR = 2.16 (1.13-4.13)), stimulant addiction (OR = 0.51 (0.26-0.98)) and being roofless/emergency sheltered at admission (OR = 0.41 (0.19-0.88)) were associated with housing stability.

Conclusion: EQIIP SOL's integrated approach yields promising results, warranting replication, robust evaluation of its efficacy, and adaptation in other settings.

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解决有早期精神病和共病物质使用的无家可归青年的复杂需求：EQIIP SOL专业外展服务10年经验的自然主义纵向研究。

目的：精神病和物质使用障碍（sud）是非常普遍的，经常在无家可归的年轻人中共同发生。EQIIP SOL是早期干预服务中的一个专门的强化外展项目，为首发精神病（FEP）无家可归的青少年提供3年的综合护理，目标是精神病，SUD和无家可归。本研究旨在检查自2012年该项目成立以来参加该项目的青年的临床和功能结果，以及住房稳定性的预测因素。方法：这项纵向研究调查了2012年至2020年EQIIP SOL收治的所有青少年的3年结果。纳入标准包括18-30岁的青年，诊断为原发性精神病和SUD，并经历无家可归。在基线和1、3、6、9、12、15、18、24和36个月后进行评估，以描述住房稳定性、疾病严重程度和一般功能演变。在基线和每年对酒精和物质使用情况进行评估。一个多变量混合效应模型研究了住房稳定性的基线预测因子。结果：在177名登记的青年中，81.4%的人至少在六个月内实现了一次住房稳定。在最初的9个月观察到疾病严重程度和一般功能的改善，此后趋于平稳。sud减少了大约三分之一；酒精使用障碍减少了一半。年龄较大（OR = 1.18(1.07-1.31)）、无长期无家可归史（OR = 2.16(1.13-4.13)）、兴奋剂成瘾（OR = 0.51(0.26-0.98)）和入院时无家可归/紧急庇护（OR = 0.41(0.19-0.88)）与住房稳定性相关。结论：EQIIP SOL的综合方法产生了有希望的结果，保证了复制，对其有效性进行了强有力的评估，并在其他环境中进行了适应。

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

期刊介绍： Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.