Assessment of health status and quality of life of homeless persons in Belgrade, Serbia
Authors: Sarajlija Marija , Jugovic Aleksandar , Zivaljevic Dragan , Merdovic Boro , Sarajlija Adrijan 
Published: February 2014

Background/Aim. Homelessness is a problem with social, medical, economic,
political and other implications. Despite a large number of studies, reports
about health-related quality of life (HRQoL) of homeless persons remain
sparse. There is a summary of consistent evidence that homeless people have
higher prevalence of chronic disease (mental and somatic) than general
population. The aim of this study was to assess HRQoL and depression in
homeless persons in Belgrade, to describe their sociodemographic factors and
health status (the presence of chronic mental and somatic diseases and
addiction disorders) and analyse impact of sociodemographic factors and
health status to HRQoL and depression of homeless persons. Methods. The study
was conducted in the Shelter for Adult and Elderly Persons in Belgrade, from
January 1 to January 31, 2012. A set of questionnaires used in survey
included Serbian translation of SF-36 questionnaire, Serbian translation of
Beck Depression Inventory-II (BDI-II) and sociodemographic questionnaire.
Statistical analysis was performed by descriptive and analytic methods.
Results. Our study sample consisted of 104 adult participants. The majority
of them were male (74%) and the mean age in the sample was 48.2 ? 13.0 years.
We have found that 35.6% participants had lifetime diagnosis of psychiatric
disorder, most frequently depression (lifetime prevalence of 15.4% in the
study group). The history of suicide attempts was registered in 28 (26.9%)
participants. Lifetime illicit drugs use was reported by 12.5%, daily smoking
by 82.7% and daily alcohol consumption by 8.7% of the participants. Most
common somatic chronic diseases were cardiovascular while chronic lung
diseases were the second most frequent. Single chronic disease was present in
33 (31.7%) of the participants and comorbidity of 2 chronic diseases was
present in 20 of them. A statistically significant difference between
participants` HRQoL SF-36 domain scores and norms of general population was
found only for role physical domain (lower in homeless, p < 0.001). ANOVA
showed no statistically significant difference in SF-36 HRQoL domain and
composite scores between different age groups, nor did marital status,
education level, length of homelessness, alcohol use or smoking significantly
affect the HRQoL. The mean BDI-II score in the studied population was 19.1 ?
11.6. Severe depression was registered in 20.2% of the participants, moderate
in 23.1%, mild in 19.2% and minimal in 37.5%. A highly significant negative
correlation was verified between BDI-II and all domains and composite scores
of SF-36 (p < 0.001). Conclusion. Measures for prevention of homelessness
should include: foundation of national registry of homeless persons,
development of systemic multisectorial cooperation and special psychosocial
intervention strategies. In homeless population, health care measures should
be focused on prevention and treatment of mental health disorders and chronic
somatic diseases.