This study investigates the screening for depressive symptoms among middle-aged and older homeless adults based on Patient Health Questionnaire-9 (PHQ-9) and examines the possible factors associated with their major depressive symptoms. A cross-sectional survey was employed, and research subjects included 129 homeless people aged 45 years old and over in Taipei Wanhua District and Taipei Main Station. We used a structured questionnaire and face-to-face interview conducted by three social workers to collect data in the analyses. The content of the questionnaire included an informed consent form, demographic characteristics, enabling and need factors of healthcare, and PHQ-9 of homeless people. Results revealed that 15.5% respondents were free of depressive symptoms, 16.3% had mild level (score 5–9), 31.8% had moderate level (score 10–14), 26.4% had moderately severe level (score 15–19), and 10.1% had severe level of depressive symptoms (score 20–27). Adopting a PHQ-9 score 10 as a cut-off point for major depressive symptoms, 68.3% of middle-aged and older homeless adults were the cases needing to be referred to healthcare settings for further recheck in the near future. A multiple regression analysis found gender, age, and usage of psychiatric outpatient care were associated with major depressive symptom occurrence. The female participants were less likely to have major depressive symptoms than the male participants (OR = 0.29, 95% CI = 0.09–0.96). The elderly participants were more likely to have major depressive symptoms than the aged 45–54 years (OR = 5.29, 95% CI = 1.44–19.41). Those participants who have ever used psychiatric outpatient care were significantly more correlated with the occurrence of major depressive symptoms than their counterparts (OR = 3.65, 95% CI = 1.46–9.09). The present study suggests that in the future health policy should eliminate the risk factors of depressive symptoms and improve mental healthcare access, to improve the health and wellbeing of the homeless population.

中文翻译：

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使用9项患者健康问卷调查中老年人和无家可归的成年人中抑郁症状的相关性。

这项研究调查了基于患者健康问卷9（PHQ-9）的中老年人和无家可归的成年人的抑郁症状筛查，并研究了与他们的主要抑郁症状相关的可能因素。进行了横断面调查，研究对象包括台北万华区和台北车站的129名45岁及以上的无家可归者。我们使用了结构化的问卷调查和由三名社会工作者进行的面对面访谈，以收集分析中的数据。问卷的内容包括知情同意书，人口统计学特征，医疗保健的启用和需求因素以及无家可归者的PHQ-9。结果显示，有15.5％的受访者没有抑郁症状，有16.3％的人处于轻度水平（5-9分），有31.8％的人有中度水平（10-14分），26。4％的患者有中度严重症状（评分15–19），而10.1％的患者有严重抑郁症状（评分20–27）。采用PHQ-9评分10作为主要抑郁症状的临界点，在不久的将来，有68.3％的中老年人和无家可归的成年人需要转诊到医疗机构进行进一步检查。多元回归分析发现，性别，年龄和精神科门诊护理的使用与严重抑郁症状的发生有关。女性参与者比男性参与者患重大抑郁症状的可能性较小（OR = 0.29，95％CI = 0.09–0.96）。与45-54岁年龄段相比，老年参与者更有可能出现严重的抑郁症状（OR = 5.29，95％CI = 1.44-19.41）。曾经使用过精神科门诊治疗的参与者与主要抑郁症状的发生率相比，与他们的参与者之间的相关性更高（OR = 3.65，95％CI = 1.46–9.09）。本研究表明，未来的健康政策应消除抑郁症状的危险因素，改善精神保健服务水平，以改善无家可归者的健康状况。