Prevalence of mental illness in homeless men in Munich, Germany: results from a representative sample

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Abstract
Objective: The aim of the study was a reliable assessment of the prevalence of DSM‐IV mental disorders in a representative sample of homeless men in the city of Munich. Method: A preliminary survey yielded an estimate of 1022 single homeless men in Munich divided among three sectors (shelter users, service users and street dwellers). A random sample of 265 single homeless men was surveyed from these three sectors. An age‐matched comparison group of 178 men was selected randomly from a community register. The Structured Clinical Interview for DSM‐IV (SCID‐IV) was used for diagnostic classification. Results: The lifetime prevalence rates of mental disorders were as follows: 72.7% vs. 15.2% for alcohol dependence, 32.8% vs. 7.3% for mood disorders, 15.9% vs. 6.2% for anxiety disorders and 9.8% vs. 0.6% for psychotic disorders. Of the homeless males in Munich, 93.2% had at least one lifetime DSM‐IV axis I diagnosis, while this was the case for only 38.2% of the community controls. One‐month prevalence for all SCID DSM‐IV axis I disorders in homeless males was 73.4%. Conclusion: Lifetime DSM‐IV axis I mental disorders were 2.4 times more frequent among homeless individuals compared to community control. Implications for health care planning are discussed.