Homeless individuals and their vulnerability to pain, depression, and sleep: narrative review

ABSTRACT

BACKGROUND AND OBJECTIVES:

This research stems from the scarcity of official data regarding the homeless population and the challenging realities faced by this group, such as social invisibility and precarious access to healthcare services. The main objective is to conduct a narrative review to understand the interconnection between chronic pain (CP), depression, and sleep disorders in this population, identifying key factors that play a role in these conditions.

CONTENTS:

The study employs a qualitative narrative review, conducting a comprehensive search in the Web of Science and Scopus databases without temporal restrictions. It utilizes English descriptors related to homelessness, depression, and sleep disorders. Globally, over 100 million people are homeless, with Brazil particularly affected by this phenomenon due to the economic crisis. The prevalence of CP in this group is linked to precarious living conditions, discrimination, and exposure to violence. The impairment of sleep quality, depression, and the bidirectional relationship between CP and depressive disorders are highlighted. Social vulnerability, lack of access to health resources, and the adversities of living conditions contribute to the complexity of challenges faced by the homeless population, negatively impacting overall health.

CONCLUSION:

Individuals experiencing homelessness face increased vulnerability to injuries, CP, depression, and sleep disorders. The bidirectional relationship between pain and depression is exacerbated by the adversities they endure. It is crucial to implement specific and effective health policies to improve living conditions, promoting equity and social justice for this vulnerable and marginalized population.

Keywords
Chronic pain; Depression; Ill-housed persons; Sleep

HIGHLIGHTS

Although they are part of society, homeless people are often socially invisible.

The high prevalence of chronic pain in these individuals is associated with frequent injuries and concomitant health problems resulting from poor living conditions.

The relationship between depression, impaired sleep quality and chronic pain directly influences mental health.