Lévesque, I. S., & Abdel-Baki, A. (2020). Homeless youth with first-episode psychosis: A 2-year outcome study. Schizophrenia Research , 216 , 460-469. https://doi.org/10.1016/j.schres.2019.10.031
What are the two to three main things you learned from the introduction?
There is a high number of homeless individuals and people without adequate housing. Some of the factors contributing to homelessness include unemployment, mental illness, family breakdown, and domestic violence. Also, homeless people have the highest rates of schizophrenia, which is associated with substance abuse, mortalities, and disabilities. Schizophrenia affects the individual and the community.
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What is one of the articles cited in the introduction? (Refer to it by the authors and the year it was published)
In the introduction, the authors used an article by Babidge et al. (2001) to explain the prevalence of schizophrenia among young people.
What is the hypothesis?
The researchers hypothesized that the first episode of psychosis among homeless youths is associated with adverse health outcomes.
How many participants were in the study?
There were 167 youths aged between 18 and 30 years who had experienced first-episode psychosis.
Who were the participants (e.g., college students, infants, etc.)?
All the participants were patients who had been admitted to an Early Psychosis Intervention Service (EIS) in Montreal, Canada.
What materials were used in the study? Did participants complete a survey, use a computer program, were they interviewed, etc.?
The researchers collected patients’ socio-demographic data, such as age, marital status, gender, and education level. They also analyzed the rate of substance abuse, medication, and community treatment. Materials such as the Calgary Depression Scale and Positive and Negative Symptoms Scale were used to assess the participants’ symptoms and functioning ( Lévesque & Abdel-Baki, 2020 ). Apart from laboratory measures, the researchers conducted oral interviews.
Summarize what the participants did
Participants filled forms that contained details about their medical adherence history. They also responded to questionnaires containing details about childhood experiences such as bullying, negligence, and abuse. Researchers wanted to understand the factors that contributed to homelessness in young people.
What was/were the independent variable(s)?
It is critical to establish causality in research. Causal variables can be dependent or independent. Independent variables determine the outcome, while the dependent variables consist of the elements being tested in an experiment (Losh, 2017). The independent variable was schizophrenia disorders in homeless youths.
What was the dependent variable?
The dependent variables included non-affective psychosis, personality, and substance abuse disorder, and adverse health outcomes.
How were the data analyzed (i.e., what statistical analysis was used)? Report the means and standard deviations for each group
The researchers used statistical tools to analyze the data. When comparing the impact of schizophrenia in young adults, the researchers compared the experiences of homeless and housed patients. Pearson’s chi-square test was used to analyze variables such as age, gender, and diagnosis ( Lévesque & Abdel-Baki, 2020 ). Also, the researchers performed descriptive statistics on all the variables. Wilcoxon and Mann-Whitney tests measured the continuous variables to determine whether the distributions were Gaussian or not. The researchers set the significance level to α≤0.002. They put all the p-values on a two-sided table and analyzed them using the SPSS-24.
Did the author(s) find a significant effect?
The authors established a significant effect in the study. Factors such as sample size and the number of trials affect the statistical power (Boudewyn et al., 2017). The number of tests needed to achieve the required level of statistical significance depends on within-participants design. In the current study, the authors used a two-year follow-up trial period to establish the impact of schizophrenia on homeless people ( Lévesque & Abdel-Baki, 2020 ). They discovered that there was a causal relationship between homeless individuals with schizophrenia and adverse health outcomes. Homeless people had a low quality of life, education, and autonomy in living arrangements.
What did you learn from the figure (graph) in the results section?
From the graph presented in the results section, one notes that most participants had experienced homelessness at some point. Even after health practitioners’ interventions, some of the participants became homeless. After the first year of admission into a mental health facility, 60% of the participants became homeless again ( Lévesque & Abdel-Baki, 2020 ). The participants could not improve their lives while in a mental health facility since schizophrenia affected their ability to concentrate and take their medications. Besides, some participants were prone to substance-abuse disorders. It was difficult for health practitioners to teach the new skills that would have benefited their lives.
Was the hypothesis supported?
The results supported the hypothesis since the researchers discovered that schizophrenia affected the health outcomes of homeless populations.
Were the results consistent with the previous literature discussed in the introduction?
The results were consistent with the previous literature found in the introduction. Most of the participants developed psychosis, cluster B personality disorder, and substance abuse disorder ( Lévesque & Abdel-Baki, 2020 ). It was evident that schizophrenia predisposes the homeless to adverse health outcomes. Compared to the non-homeless population, homeless individuals with schizophrenia had higher rates of substance abuse disorder. Besides, most homeless individuals did not adhere to the proposed treatments. Health practitioners experience challenges when attempting to administer antipsychotic medications ( Lévesque & Abdel-Baki, 2020 ). Homeless people with schizophrenia experience delusional thoughts, and thus, they have negative perceptions toward health practitioners. Living in the streets makes a person lose hope about their future. Most patients with schizophrenia use drugs such as cannabis and cocaine, hoping that it would alleviate the disease's symptoms. Such behaviors exacerbate the symptoms of schizophrenia, making it difficult for medical practitioners to establish therapeutic relationships with them. In the study, about 77% of the homeless people with schizophrenia were re-hospitalized after experiencing adverse health outcomes ( Lévesque & Abdel-Baki, 2020 ). Individuals with schizophrenia who lived in well-established homes were likely to seek mental healthcare since they have adequate social support from friends, peers, and family members. On the contrary, most of the homeless individuals do not have positive support. Hence the reason two study participants died from substance abuse disorders ( Lévesque & Abdel-Baki, 2020 ). Certain risk factors propagate the prevalence of schizophrenia in homeless populations. For example, the spread of HIV/AIDS and tuberculosis enhances schizophrenia among homeless individuals (Ayano et al., 2019). Some homeless people have also been exposed to physical and sexual abuse. Besides, homelessness is linked to psychological distress due to a lack of fundamental needs, such as food, security, and house. The people living in such conditions lack adequate problem-solving strategies. As a result, they are likely to develop chronic psychotic disorders.
What can you conclude from this study?
From this study, one concludes that schizophrenia is prevalent among homeless people. This mental disorder adversely affects the health outcomes of homeless individuals. It encourages them to take drugs like cannabis and cocaine to avoid psychological distress associated with their living conditions. Besides, schizophrenia makes it difficult for homeless individuals to seek healthcare services (Smith & Castaneda, 2020). This disorder affects patients’ preferences, choices, and executive functions. Despite the negative consequences of schizophrenia, very few studies have focused on its impacts on homeless populations.
Did the author(s) make any suggestions for future investigation? If so, what suggestion was made?
The authors suggested further investigation. They stated that future studies should focus on providing fundamental needs to homeless people to improve their health outcomes within the first five years of diagnosis of schizophrenia. The authors believe that this period is critical since it can determine whether the health practitioners’ intervention can alleviate the prevalence of schizophrenia among homeless people.
What did you think of the article?
This article has its strengths and limitations. Some of its strengths include assessing homeless individuals’ socio-demographic factors, symptoms, treatment, and service utilization. This approach enhanced the understanding of the impact of schizophrenia on the homeless population. Besides, the authors collected data longitudinally, allowing identification of different factors associated with homelessness. However, this study focused on young people, making it challenging to apply the findings to the general homeless population. Also, the follow-up period was inadequate to establish the impact of schizophrenia among homeless people. The researchers should have investigated the homeless population for five years to determine this population's health outcome. Regardless, the study provided significant insights into the impact of schizophrenia on homeless people.
Was it an effective study? Do you accept the results? Why or why not?
The study was compelling since the authors compared the impact of schizophrenia between homeless and non-homeless populations. This approach enables an audience to gain an in-depth understanding of the effects of schizophrenia. Besides, the studies focused on young people who are highly prone to schizophrenia. For this reason, the study’s findings are valid and can be used to inform healthcare practice.
How many references were cited in the article?
This research had adequate evidence from peer-reviewed resources. The authors used 47 articles from credible sources ( Lévesque & Abdel-Baki, 2020 ). Therefore, the study findings are trustworthy and can be used to inform healthcare practice.
References
Ayano, G., Tesfaw, G., & Shumet, S. (2019). The prevalence of schizophrenia and other psychotic disorders among homeless people: A systematic review and meta-analysis. BioMed Central Psychiatry , 19 (1), 370. https://doi.org/10.1186/s12888-019-2361-7
Boudewyn, M. A., Luck, S. J., Farrens, J. L., & Kappenman, E. S. (2018). How many trials does it take to get a significant ERP effect? It depends. Psychophysiology , 55 (6), e13049. https://doi.org/10.1111/psyp.13049
Lévesque, I. S., & Abdel-Baki, A. (2020). Homeless youth with first-episode psychosis: A 2-year outcome study. Schizophrenia Research , 216 , 460-469. https://doi.org/10.1016/j.schres.2019.10.031
Losh, S. C. (2017). Dependent and independent variables. The Wiley‐Blackwell Encyclopedia of Social Theory , 1-3. https://doi.org/10.1002/9781118430873.est0622
Smith, C., & Castañeda, E. (2020). Sick enough? Mental illness and service eligibility for homeless individuals at the border. Social Sciences , 9 (8), 145. https://doi.org/10.3390/socsci9080145
