Homelessness is associated with multiple adversities that might impact upon brain function. We performed a review of published work to assess evidence of cognitive dysfunction among adults who are homeless. Despite liberal inclusion criteria only seventeen publications were identified, these describing eighteen samples mainly from the USA. Although the total number of individuals studied is small (about 3300) and the samples are heterogeneous, most studies indicate a considerable burden of cognitive dysfunction among homeless people. Such dysfunction might be expected to impact upon their ability to reintegrate into society, thereby undermining policies of inclusiveness. In clinical practice, assessment of homeless adults should include their cognitive state.
SpenceS.A., HunterM.D., HarpinG.Neuroscience and the will.Curr Opin Psychiatry2002; 15: 519–26
8.
EggerM., SmithG.D., AltmanD.G., eds. Systematic Reviews in Health Care: Meta-analysis in Context, 2nd edn.London: BMJ Publishing, 2001
9.
GlasziouP., IrwigL., BainC., ColditzG.Systematic Reviews in Health Care: a Practical Guide.Cambridge: Cambridge University Press, 2001
10.
NHS Centre for Reviews and Dissemination.Undertaking Systematic Reviews of Research on Effectiveness: Guidance for those Carrying out or Commissioning Systematic Reviews. Report No. 4, 2001
11.
MuñozM., VazquezC., KoegelP., SanzJ., BurnamM.A.Differential patterns of mental disorders among the homeless in Madrid (Spain) and Los Angeles (USA).Soc Psychiatry Psychiatr Epidemiol1998; 33: 514–20
12.
FischerP.J., ShapiroS., BreakeyW.R., AnthonyJ.C., KramerM.Mental health and social characteristics of the homeless: a survey of mission users.Am J Pub Health1986; 76: 519–24
13.
KoegelP., BurnamA., FarrR.K.The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles.Arch Gen Psychiatry1988; 45: 1085–92
14.
LouksJ.L., SmithR.Homeless: Axis I disorders.Hosp Commun Psychiatry1988; 39: 670–71
BoccellariA.A., DilleyJ.W.Management and residential placement problems of patients with HIV-related cognitive impairment.Hosp Commun Psychiatry1992; 43: 32–7
17.
CotmanA., SandmanC.Cognitive deficits and their remediation in the homeless.J Cogn Rehab1997; 15: 16–24
18.
SeidmanL.J., CaplanB.B., TolomiczenkoG.S.. Neuropsychological function in homeless mentally ill individuals.J Nerv Ment Dis1997; 185: 3–12
19.
DouyonR., GuzmanP., RomainG.. Subtle neurological deficits and psychopathological findings in substance abusing homeless and non-homeless veterans.J Neuropsychiatry Clin Neurosci1998; 10: 210–15
20.
GonzalezE.A., DieterJ.N.I., NataleR.A., TannerS.L.Neuropsychological evaluation of higher functioning homeless persons: a comparison of an abbreviated test battery to the Mini Mental State Exam.J Nerv Ment Dis2001; 189: 176–81
21.
TeessonM., BuhrichN.Prevalence of cognitive impairment among homeless men in a shelter in Australia.Hosp Commun Psychiatry1993; 44: 1187–9
22.
AdamsC.E., PantelisC., DukeP.J., BarnesT.R.E.Psychopathology, social and cognitive functioning in a hostel for women.Br J Psychiatry1996; 168: 82–6
23.
BremnerA.J., DukeP.J., NelsonH.E., PantelisC., BarnesT.R.E.Cognitive function and duration of rooflessness in entrants to a hostel for homeless men.Br J Psychiatry1996; 169: 434–9
24.
FichterM.M., KoniarczyK, GreifenhagenA.. Mental illness in a representative sample of homeless men in Munich, Germany.Eur Arch Psychiatry Clin Neurosci1996; 246: 185–96
25.
GeddesJ.R., NewtonJ.R., BaileyS., FreemanC., YoungG.The chief scientist reports…. Prevalence of psychiatric disorder, cognitive impairment and functional disability among homeless people resident in hostels.Health Bull (Edinb)1996; 54: 276–9
26.
BuhrichN., HodderT., TeessonM.Prevalence of cognitive impairment among homeless people in inner Sydney.Psychiatr Serv2000; 51: 520–1
27.
San AgustinM., CohenP., RubinD., ClearyS.D., EricksonC.J., AllenJ.K.The Montefiore community children's project: a controlled study of cognitive and emotional problems of homeless mothers and children.J Urban Health1999; 76: 39–50
28.
RubinD.H., CandaceJ., San AgustinM., ClearyS.D., AllenJ.K., CohenP.Cognitive and academic functioning of homeless children compared with housed children.Pediatrics1996; 97: 289–94
29.
KassF., SilverJ.M.Neuropsychiatry and the homeless.J Neuropsychiatry Clin Neurosci1990; 20: 15–19
30.
HodgesJ.R.Cognitive Assessment for Clinicians.Oxford: Oxford University Press, 1994
31.
DansecoE.R., HoldenE.W.Are there different types of homeless families? A typology of homeless families based on cluster analysis.Fam Relat1996; 47: 159–65
32.
JablenskyA., SartoriusN., ErnbergG.. Schizophrenia: manifestations, incidence and course in different countries. A World Health Organization ten-country study.Psychol Med Monogr Suppl1992; 20: 1–97
33.
HeinrichsR.W., ZakzanisK.K.Neurocognitive deficit in schizophrenia. A quantitative review of the evidence.Neuropsychology1998; 12: 426–45
