Course of Alcoholism in Homeless Men in Munich, Germany: Results from a Prospective Longitudinal Study Based on a Representative Sample

Abstract

In an earlier paper (Fichter, M. M., Quadflieg, N. (). Alcoholism in homeless men in the mid-nineties: results from the Bavarian Public Health Study on Homelessness. European Archives of Psychiatry and Clinical Neuroscience 249:34–44), we reported data on alcoholism and comorbidity in 265 homeless men in Munich. There—as in this paper—we divided the sample into three groups based on a lifetime diagnosis of alcohol dependence (N = 187), alcohol abuse (N = 17), and no diagnosis of alcoholism (N = 61) at baseline assessment. This study reports a three-year prospective longitudinal assessment of the original representative sample of homeless men in Munich. Interviews at baseline and at follow-up included the SCID-I and covered several other areas (cognitive impairment, somatic complaints, use of medical services, and other psychosocial variables). Of 247 homeless men still alive, at three-year follow-up, 185 (74.9%) were successfully traced and personally interviewed. Alcohol dependency in homeless men at first wave assessment (as compared to men not manifesting alcohol abuse or dependence) was associated with a higher proportion of homelessness at three-year follow-up, an increase of alcohol consumption at three-year follow-up, reduction of monthly income, higher death rate, and high use of general medical services but very low utilization of (specific substance) user treatment services. Alcoholism in homeless men constitutes a posited risk factor for an unfavorable course over time with regard to such a person's living situation and health status in spite of more utilization of medical services.

• Mental illness
• Homelessness
• Alcoholism
• Structured Clinical Interview for DSM-IV (SCID)
• Psychiatric epidemiology
• Course of illness
• Longitudinal study

Additional information

Notes on contributors

Manfred M. Fichter

Manfred Fichter, M.D., Dipl.-Psych., (born September 19, 1944) is Professor of Psychiatry at the Ludwig-Maximilians-University of Munich, Germany and Medical Director of hospital “Psychosomatische Klinik Roseneck” (behavioral medicine) in Prien, Germany, affiliated with the Medical Faculty of the Ludwig-Maximilians-University of Munich, Germany. He has been interested in mental illness in homeless people for more than 25 years. He has published extensively on eating disorders and other psychosomatic illnesses as well as on mental illness in the general population. He is head of the Upper Bavarian study, a large representative study on the course of mental illness in the general population. Prof. Fichter was awarded several prizes and is on the editorial board of several international journals.

Norbert Quadflieg

Norbert Quadflieg, Dipl.-Psych., (born October 9, 1957) has a university degree as “Diplom-Psychologe” and is a clinical research specialist with expertise in epidemiological research on mental illness in homeless people of more than 10 years. Other areas of research include the course of eating disorders and mental illness in the general population.