ABSTRACT
OBJECTIVE: Homeless people suffer high levels of psychological distress. The aim of the present work was to study the immune function in a group of homeless people with stress-related disorders and compare it with that of healthy non-homeless controls. METHODS: We included in the study 40 homeless persons and 40 housed controls recruited from the population of Madrid and matched for age and gender. Samples from peripheral blood were collected and we studied several leukocyte functions previously described as good health and survival markers [adherence, chemotaxis, phagocytosis, superoxide anion levels, lymphocyte proliferation in response to phytohemagglutinin, NK activity and cytokine (IL-2, TNF-alpha) levels], as well as other related parameters, such as plasma cortisol levels and total antioxidant capacity. RESULTS: There was a strongly suppressed immune response in the homeless group, with decreased adherence, chemotaxis, phagocytosis, superoxide levels, lymphoproliferation and NK activity. IL-2 and plasma antioxidant levels were also impaired. CONCLUSIONS: These findings suggest an altered immune function in the homeless population that might be responsible for the higher morbidity and mortality of homeless people. In addition, the present work points out directions for future research attempting to increase the quality of life and health status of homeless individuals, since it shows that oxidative stress seems to play a key role in this immune function impairment.
Subject(s)
Ill-Housed Persons/psychology , Immune Tolerance/immunology , Stress, Psychological/immunology , Adolescent , Adult , Aged , Antioxidants/metabolism , Anxiety Disorders/epidemiology , Anxiety Disorders/immunology , Chemotaxis, Leukocyte/immunology , Comorbidity , Depressive Disorder/epidemiology , Depressive Disorder/immunology , Female , Ill-Housed Persons/statistics & numerical data , Humans , Interleukin-2/blood , Killer Cells, Natural/immunology , Lymphocyte Activation/immunology , Male , Middle Aged , Oxidative Stress/immunology , Phagocytosis/immunology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/immunology , Stress, Psychological/blood , Stress, Psychological/epidemiology , Young AdultABSTRACT
Symptoms of stress are prevalent among the homeless. Growing evidence suggests that disclosure of traumatic experiences is beneficial to health. This pilot study examined the effects of an emotional disclosure protocol on a group of 8 homeless people, using a single-group design. Clinical effectiveness was evaluated using the Impact of Event Scale, the Beck Depression Inventory, the Beck Anxiety Inventory, the Perceived Stress Scale, the Reading Span Task, and the Digit Span Test. Participant satisfaction was also measured. Results showed significant improvements in functioning at 1- and 6-week follow-up, and good satisfaction levels. The discussion remarks on the limitations (lack of a control group, small sample size, and other biases) and the need for more research in this topic.
