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

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 1,022 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.