Prevalence of Homeless Mentally Ill Patient along with their Clinical Presentation at Government Setup in Western Uttar Pradesh State of India

Abstract

Context: Homeless persons lack socioeconomic support which is instrumental in affecting both their physical as well as psychological health. A number of destitute persons are often brought to specialized psychiatric centres in view of their dilapidating physical and psychological health.Aim: To study the prevalence and clinical presentation among the destitute persons admitted to a specialized psychiatric care centre.Materials & Methods: A total of 100 destitute persons admitted to a specialized psychiatric care centre were included in the study as a retrospective chart review. Demographic profile and clinical presentations were noted. The classification of psychiatric illnesses was done as per international classification of diseases (ICD)-10 classification. Data has been represented in frequencies (number) and percentages.Results: Age of patients ranged from 15 to 75 years. Mean age of patients was 40.70 ± 13.99 years. Majority (62%) were males and Hindus (57%). Poor personal hygiene (79%), abnormal behavior (52%) and self-muttering (44%) were the most common presenting complaints. On mental status examination, irrelevant speech (85%), restricted/perplexed affect (93%), impaired judgement (98.8%), impaired attention and concentration (90.7%) and impaired memory (80%) were the major findings. CNS and GI abnormalities were seen in 9% and 2% patients. Almost all (99%) had non-cooperative attitude, inadequate skin/nail care (94%). Majority (56%) had thin to very thin built and psychomotor agitation (55%). Unspecified nonorganic psychosis (44%) was the most common psychiatric illness followed by paranoid schizophrenia (10%) and organic delirium (6%). In 28% cases, the psychiatric illness could not be established clearly, and were kept under observation.Conclusion: Destitute persons have a huge burden of psychiatric illness that had affected their physical health too.