Is bipolar disorder associated with tramautic brain injury in the homeless?


Links between Bipolar Disorder (BD) and medical conditions are increasingly reported. Traumatic Brain Injury (TBI) is a prevalent medical condition found in homeless populations.


This paper examines the correlation between the presence of BD and TBI, comparing homeless affected by Bipolar Disorder, Unipolar Depression (UD) and Schizophrenia Spectrum Disorder (SSD), controlled for other TBI risk factors such as age, gender, comorbid alcohol and substance use disorders as the confounding variables. 


From 489 participants of Vancouver arm of the At Home/Chez Soi Study, 416 homeless had psychiatric diagnoses, alcohol and substance dependence, and TBI determined by the MINI Questionnaire and the Comorbid Conditions List. 147 patients with BD were compared with 175 UD and 94 SSD for age, gender, the presence, number and severity of TBI and the presence of alcohol and substance use diagnosis, at a univariate and multivariate level. 


The homeless with BD had higher percentage of TBI compared to the homeless with SSD. However, the reported severity and frequency of TBI by patients with BD, UD, and SSD were not statistically different. BD diagnosis was associated with TBI at multivariate level. Conclusions. TBI could be considered one of the physical burdens associated with BD in the homeless population

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Rivista di Psichiatria