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Carol S. North, MD, MPE, Karin M. Eyrich, MSW, MPE, David E. Pollio, PhD and Edward L. Spitznagel, PhD

Carol S. North is with the Dept of Psychiatry, Washington University School of Medicine, St Louis, Mo. Karin M. Eyrich is with the Dept of Psychiatry and George Warren Brown School of Social Work, Washington University School of Medicine. David E. Pollio is with the George Warren Brown School of Social Work, Washington University School of Medicine. Edward L. Spitznagel is with the Dept of Mathematics and Biostatistics, Washington University.

Correspondence: Requests for reprints should be sent to Carol S. North, MD, MPE, Washington University School of Medicine, Dept of Psychiatry, 660 South Euclid Ave, St Louis, MO 63110 (e-mail: northc{at}psychiatry.wustl.edu).

Objectives. We examined the prevalence of psychiatric illness among 3 homeless populations in St. Louis, Mo, in approximately 1980, 1990, and 2000. The 3 studies were conducted with the same systemic research methodology.

Methods. We compared selected demographics and lifetime substance abuse and dependence and other mental illness among the 3 populations.

Results. Among the homeless populations we studied, the prevalence of mood and substance use disorders dramatically increased, and the number of minorities within these populations has increased.

Conclusions. The prevalence of psychiatric illness, including substance abuse and dependence, is not static in the homeless population. Service systems need to be aware of potential prevalence changes and the impact of these changes on service needs.

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