title: Mental illness and substance use among sheltered homeless persons in lower-density population areas.
abstract: OBJECTIVE
  The prevalence of mental illness and substance abuse in homeless populations has been studied primarily in large urban areas. This study examines a sheltered homeless population in two counties of lower-density population, Dauphin and Cumberland counties in central Pennsylvania, to assess the prevalence of mental illness and substance abuse.
  
  
  METHODS
  A total of 81 homeless adults from nine emergency shelters were interviewed using a structured questionnaire.
  
  
  RESULTS
  The estimated lifetime prevalence rate of major depressive disorder was 26.6 percent; 6.4 percent of the sample showed evidence of psychotic thinking. Almost one-third reported previous hospitalization for emotional problems, and about one-third reported a suicide attempt. The estimated lifetime prevalence rate of alcohol or drug abuse or dependence was almost 60 percent.
  
  
  CONCLUSIONS
  Although mental illness, especially psychosis, and substance abuse may be somewhat less prevalent among homeless persons in lower-density population areas than in large urban areas, they are nevertheless significant problems.
authors.affiliation: Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey 17033, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Kales
authors.forename: M A
authors.initials: MA
authors.lastname: Barone
authors.forename: E O
authors.initials: EO
authors.lastname: Bixler
authors.forename: M M
authors.initials: MM
authors.lastname: Miljkovic
authors.forename: J D
authors.initials: JD
authors.lastname: Kales
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D010414:Pennsylvania; D010552:Personality Assessment; D011156:Population Density; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012424:Rural Population / Q000706:statistics & numerical data*; D012931:Social Environment; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data