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Biomedical subjects

E Susser

Publications and source records attributed to E Susser.

82 records · Page 5Linked to original sources
PubMed1990

Some clinical approaches to the homeless mentally ill.

Clinicians who work with homeless people are likely to encounter a very broad spectrum of mental disorders and residential patterns. As with any other patient population, the particulars of clinical interventions must be guided by the specific constellations of biological, psychological, and social needs. However, for individuals who not only suffer from serious psychiatric disorders, but are also homeless, effective approaches may require significant modifications of traditional techniques and changes in the prioritization, timing, and framing of specific interventions. In this article we will focus on people who are severely and persistently mentally ill and who have been sleeping for months or years in shelters or in public spaces such as parks, streets, and bus terminals.

Chronic Disease↗
PubMed1989

Psychiatric problems in homeless men. Lifetime psychosis, substance use, and current distress in new arrivals at New York City shelters.

We assessed psychiatric states in 223 men at first entry to New York, NY, municipal men's shelters, overall and differentiated by prior experience of homelessness. Instruments included a diagnostic interview (Structured Clinical Interview for DSM-III-R: Psychotic Disorders), the Short Michigan Alcoholism Screening Test, and the Center for Epidemiologic Studies of Depression Scale. The use of a "first timer" sample, and of a clinical diagnostic interview, had not, to our knowledge, been previously attempted in studies of psychiatric problems in the homeless. The majority of men had a history of mental disorder or of heavy substance use. On diagnostic interview, 17% of the men had a definite or probable history of psychosis, and another 8% had a possible history of psychosis. A confident diagnosis of schizophrenia was made in 8%. A history of alcohol or other drug abuse was evident in 58%. Cocaine was already (in 1985) the drug of choice; 27% of the study sample had used it more than 50 times. One third of the men were in extreme distress, much of it apparently acute and associated with the transition to the shelter, and 7% reported suicidal thoughts at the time of the interview. The newly homeless, compared with those who had been homeless for much of the 5 years prior to shelter entry, were younger and had fewer psychiatric problems.

Adolescent↗
PubMed1989

Problems of epidemiologic method in assessing the type and extent of mental illness among homeless adults.

Because the problem of homelessness has generated such attention and controversy, findings from studies of homeless populations are often received eagerly without appreciation of the significant biases inherent in surveys. Drawing on surveys of the homeless made in the 1980s, the authors review problems in sampling and in measurement of mental disorder. They suggest that within any one study researchers employ alternative sampling strategies and measures of mental disorder to facilitate comparison of results within and across studies.

Epidemiologic Methods↗
PubMed1987

Childhood experiences of homeless men.

The authors interviewed homeless men in New York City shelters about their childhood experiences. Childhood placement away from the family was frequent, especially among former psychiatric patients. Childhood problem behaviors were also frequent.

Adolescent↗
PubMed1987

Indicators and designs in genetic epidemiology: separating heredity and environment.

The problems of separating highly confounded hereditary and environmental factors are reviewed from an epidemiological point of view. Once the fact rather than the appearance of familial aggregation is established, one can search for and analyze strong indicators of either genetic or environmental effects, and ultimately attempt their separation by strong design. Indicators of genetic effects are classified according to the presence or absence of family recurrence. In the presence of family recurrence, three analytic approaches are available: segregation analysis, linkage, and heritability estimates. In the absence of family recurrence, biological markers and endogamous groups can be used. Indicators of environmental effects are also classified according to the presence or absence of family recurrence of a disorder. In the presence of family recurrence, three environmental indicators are considered: non-Mendelian clustering, such as time of onset versus age in family clusters, and sex clusters; cohabitational effects; and maternal transmission. In the absence of family recurrence, environmental indicators include secular trends, migration, time and place clusters, family size, and birth order. Designs that aim to separate heredity and environment include twin studies, fixed clusters that include a variety of degrees of relatedness (particularly the family set-design), and comparisons of separately reared relatives. The strengths and weaknesses of twin studies and family set designs are reviewed. Separately reared relatives provide the most cogent tests of genetic and environmental hypotheses. Among these, separated twin pairs, half-sibs, and relatives separated through institutional placement or adoption are considered. Adoption strategies are illustrated by the Danish adoption studies of schizophrenia, criminality, and alcoholism, and these studies are reanalyzed from the perspective of epidemiological case-control and cohort studies. Finally, the potential uses of multiple family settings as they occur in the general population are briefly discussed.

Environment↗
PubMed1983

Spontaneous abortion and induced abortion: an adjustment for the presence of induced abortion when estimating the rate of spontaneous abortion from cross-sectional studies.

The existence of high rates of induced abortion in the population may distort currently employed measures of the rate of spontaneous abortion. Since the frequency of induced abortion varies greatly between and within populations, an appropriate correction is needed to restore the comparability of spontaneous abortion rates. A simplified estimate of the "true" rate of spontaneous abortion is proposed. This statistic yields a sufficient approximation for most purposes.

Abortion, Induced↗