Traumatic Brain Injury Common Amongst Homeless People, CMAJ

Main Category: Neurology / Neuroscience
Also Included In: Psychology / Psychiatry;  Alcohol / Addiction / Illegal Drugs;  Mental Health
Article Date: 07 Oct 2008 - 2:00 PDT

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Traumatic brain injury is common amongst homeless people and is associated with poorer health, found a study of more than 900 homeless men and women in Toronto. Health problems include an increased risk of seizures, mental health problems, drug problems, and poorer physical and mental health status.

In this study of people in Toronto's shelter system or who use meal programs, 58% of homeless men and 42% of homeless women had a history of traumatic brain injury. All participants had valid provincial health insurance. For many people, the first incidence of traumatic brain injury often occurred at a young age and "suggests that, in some cases, traumatic brain injury may be a causal factor that contributes to the onset of homelessness, possibly through cognitive or behavioural sequelae of traumatic brain injury," state Dr. Stephen Hwang, a physician and research scientist at St. Michael's Hospital, and coauthors. Traumatic brain injury can result from falls, physical abuse, motor vehicle accidents and assaults.

These findings have implications in providing health care to homeless people, as some difficult behaviours in patients may be due to the results of brain injury. Appropriate supports may help mitigate the effects of these behaviours, suggest the authors.

There have only been 2 previous studies of this kind, both of which had small sample sizes.

Health care professionals need to ask homeless people if they have had traumatic brain injuries when providing health care. Neuropsychological screening, referral to rehabilitation programs and other community supports should be considered for the individual, write the authors.

About CMAJ

CMAJ is the leading health sciences journal in Canada. CMAJ is a general medical journal publishing original research and review articles, commentaries and editorials, practice updates, an arts and ideas section and health news. Published continuously since 1911, new issues are uploaded on http://www.cmaj.ca every second Monday at 4:30 p.m. EST/EDT. http://www.cmaj.ca contains the complete editorial contents of CMAJ, supplemented by a variety of interactive features and additional content.

CMAJ is an open- and free-access journal - there are no author or page charges and access is provided free on the web (HighWire Press), http://www.cmaj.ca without registration. http://www.cmaj.ca has about 1 million requests and 250,000 page views per month. The Journal is part of the PubMed Central collection of journals http://www.pubmedcentral.nih.gov at the National Library of Medicine thus providing a guarantee of permanent archiving and open access. PubMed Central is now processing back issues of CMAJ to 1911.

CMAJ's impact factor - a measure of the scientific importance of articles published - has more than tripled since 1997 and is now 7.1.

The Journal receives about 2000 manuscripts a year (including letters to the editor and news articles). CMAJ's acceptance rate for unsolicited research and review articles is about 12%.

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