Unseen Struggles: Impacts of Homelessness on Women with Schizophrenia

Since schizophrenia profoundly impacts cognitive, social, and occupational domains, the condition can sometimes lead to homelessness, exacerbating its difficulties. Women experiencing schizophrenia and homelessness are particularly vulnerable due to societal and gender disparities, compounded by the lack of adequate mental health resources and social support systems.

A recent study investigated cognitive functioning, illness severity, and functional ability in women with schizophrenia experiencing homelessness (WSH) in India. This study sought to address the significant gap in research on this population by comparing the group’s cognitive functioning to an age-matched group of women with schizophrenia living with their family (WSF). Here’s an in-depth look at the study.

The Methodology of the Study

The cross-sectional observational study evaluated 68 women with schizophrenia: 36 in the WSH group and 32 in the WSF group.

Participants were assessed for cognitive functioning using the Montreal Cognitive Assessment (MOCA) and the Rowland Universal Dementia Assessment Scale, psychopathology using the Scale for Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS), and disability using the World Health Organization Disability Assessment Scale (WHO-DAS).

The Results of the Study

The study found significant differences between the WSH and WSF groups, particularly regarding:

• Cognitive impairments

• WSH exhibited significantly lower cognitive scores across all assessments. On average, their MOCA scores were 16.79 (±7.01) compared to 23.32 (±3.39) in the WSF group.
• Severe impairments in frontal and executive functions were observed, indicative of deficits in planning, reasoning, and working memory.

• Psychopathology

• The WSH group had substantially higher SAPS and SANS scores, reflecting more severe positive symptoms, like hallucinations and delusions, and negative symptoms, including apathy and social withdrawal. These findings suggest a more severe illness trajectory.
• Functional disability
• WHO-DAS scores indicated significantly higher disability in WSH, averaging 55.57 percent compared to 23.45 percent in WSF.
• Treatment
• WSH were prescribed higher doses of antipsychotics, often with limited clinical response.

The Implications of These Findings

Women experiencing schizophrenia and homelessness face severe cognitive impairments, heightened psychopathology, and profound functional disabilities in comparison to women with schizophrenia living with family.

Addressing these challenges requires a tailored and multidisciplinary approach, combining early cognitive interventions, robust social support systems, and innovative pharmacological treatments. This study underscores the critical need for tailored interventions to improve outcomes for this marginalized population.

Reference:

Menon J, Kantipudi SJ, Mani A, Radhakrishnan R. Cognitive functioning and functional ability in women with schizophrenia and homelessness. Schizophr Res Cogn. 2025;39:100338. doi:10.1016/j.scog.2024.100338