PERSONAS SIN HOGAR: CONSUMO DE ALCOHOL Y/O OTRAS DROGAS, PROBLEMAS DE SALUD MENTAL Y VIOLENCIA

Lima, Diellison Layson dos Santos; Lira, Jefferson Abraão Caetano; Ribeiro, Ítalo Arão Pereira; Pillon, Sandra Cristina; Fernandes, Márcia Astrês

doi:10.1590/1980-265X-TCE-2025-0204en

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Original Article • Texto contexto - enferm. 35 • 2026 • https://doi.org/10.1590/1980-265X-TCE-2025-0204en linkcopiar

PERSONAS SIN HOGAR: CONSUMO DE ALCOHOL Y/O OTRAS DROGAS, PROBLEMAS DE SALUD MENTAL Y VIOLENCIA

Autoría SCIMAGO INSTITUTIONS RANKINGS

Objetivo: analizar la asociación entre el consumo de alcohol y/u otras drogas, el distrés mental y la violencia en personas en situación de calle.

Método: se realizó un estudio transversal analítico en una capital del noreste de Brasil con 127 personas en situación de calle. Los datos se recopilaron mediante un cuestionario para caracterizar las condiciones sociodemográficas, económicas y de vida, así como la violencia, la Alcohol, Smoking and Substance Involvement Screening Test, y el Self-Reporting Questionnaire entre octubre de 2019 y marzo de 2020. En el análisis inferencial, se realizaron las pruebas de asociación de Chi-cuadrado y la prueba exacta de Fisher, considerando un valor p<0,05 como significativo.

Resultados: la mayoría reportó que vivir en la calle es un factor predisponente para el consumo de sustancias psicoactivas (69,3 %). La prevalencia de distrés mental entre las personas en situación de calle fue del 63 %. Entre los tipos de violencia, el 36,3 % autoreportó haber sufrido violencia psicológica, el 32,7 % violencia física, el 20,2 % violencia contra la propiedad y el 5,4 % violencia sexual u otros tipos de violencia. Se observó una asociación significativa entre la violencia sexual y el distrés mental (p=0,02), el consumo problemático de tabaco y otros tipos de violencia (p=0,01), el consumo problemático de alcohol y la violencia física (p=0,04) y la violencia contra la propiedad (p=0,005), así como el consumo problemático de marihuana con otros tipos de violencia (p=0,01). La violencia autoinfligida también mostró una asociación con la violencia física (p=0,048), la violencia sexual (p=0,033) y el distrés mental (p=0,017).

Conclusión: la violencia tuvo implicaciones en el distrés mental, el consumo problemático de sustancias psicoactivas y la violencia autoinfligida entre las personas sin hogar.

DESCRIPTORES:
Personas en situación de pobreza; Consumo excesivo de alcohol; Consumidores de drogas; Salud mental; Violencia

Variables	Sociodemographic and economic characteristics
Variables	n (%)	Minimum and Maximum	Mean ± SD*	Median
Age (years)		19 - 72	39.2±11.9	37
Sex
Male	108 (85)
Female	19 (15)
Marital Status
Single	75 (59.1)
Married	8 (6.3)
Separated/Divorced	28 (22)
Widowed	4 (3.1)
Stable Relationship	12 (9.4)
Race/Color
White	22 (17.3)
Black	27 (21.3)
Yellow	1 (0.8)
Brown	77 (60.6)
Education Level
Illiterate	9 (7.1)
Elementary School (Completed/Incomplete)	74 (58.2)
High School (Completed/Incomplete)	40 (31.5)
Higher Education (Completed/Incomplete)	4 (3.1)
Income
Pension (minimum wage)	11(8.7)
Government Benefit	37 (29.1)
Self-Employed	30 (23.6)
None	49 (38.6)
Children
Yes	69 (54.3)
No	58 (45.7)
Living conditions
Origin
State capital	53 (41.7)
Interior	25 (19.7)
Other state	49 (38.6)
Motivation for living on the street
Alcohol and other drugs	44.4 (24.4)
Unemployment	35 (19.4)
Family conflicts	71 (39.4)
Violence	11 (6.1)
Mental illness	3 (1.7)
Natural disasters	1 (0.6)
Other	15 (8.3)
Is living on the streets a predisposing factor for the use of psychoactive substances?
Yes	88 (69.3)
No	38 (29.9)
Did not respond	1 (0.8)
Time spent living on the streets	1 - 2 years	1.70±0.46		2

Groups of symptoms	Yes	No
Groups of symptoms	n (%)	n (%)
Depressed mood/anxious
Are you easily startled?	67 (52.8)	60 (47.2)
Do you feel nervous, tense, or worried?	89 (70.1)	38 (29.9)
Have you been feeling sad lately?	100 (78.7)	27 (21.3)
Have you been crying more than usual?	62 (48.8)	65 (51.2)
Somatic symptoms
Do you have frequent headaches?	57 (44.9)	70 (55.1)
Do you have a lack of appetite?	51 (40.2)	76 (59.8)
Do you sleep poorly?	80 (63.0)	47 (37.0)
Do you have hand tremors?	55 (43.3)	72 (56.7)
Do you have indigestion?	22 (17.3)	105 (82.7)
Do you have unpleasant sensations in your stomach?	37 (29.1)	90(70.9)
Decrease in vital energy
Do you have difficulty thinking clearly?	55 (43.3)	72 (56.7)
Do you find it difficult to perform your daily activities with satisfaction?	47 (37.3)	79 (62.7)
Do you have difficulty making decisions?	54 (42.5)	73 (57.5)
Do you have difficulties at work (is your work arduous, does it cause suffering)?	24 (18.9)	103 (81.1)
Do you feel tired all the time?	69 (54.3)	58 (45.7)
Do you tire easily?	65 (51.2)	62 (48.8)
Depressive thoughts
Are you unable to play a useful role in your life?	28 (22.0)	99(78.0)
Have you lost interest in things?	50 (39.4)	77(60.6)
Do you feel like a useless, worthless person?	29 (23.0)	97(77.0)
Have you had thoughts of ending your life?	36 (28.3)	91(71.7)

Self-reported violence	Mental Distress (SRQ-20)
	Yes	No	p-value*
	n (%)	n (%)	p-value*
Physical			0.50
Yes	46 (63.0)	27 (37.0)
No	33 (64.7)	18 (35.3)
Sexual			0.02
Yes	11 (91.7)	1 (8.3)
No	68 (60.7)	44 (39.3)
Psychological			0.11
Yes	48 (59.3)	33 (40.7)
No	31 (72.1)	12 (27.9)
Patrimonial			0.37
Yes	30 (66.7)	15 (33.3)
No	49 (62.0)	30 (38.0)
Other			0.30
Yes	9 (75.3)	3 (25.0)
No	70 (62.5)	42(0.9)
Is experiencing violence a predisposing factor for the use of psychoactive substances?			0.06
Yes	44 (71.0)	18 (29.0)
No	36 (55.4)	29 (44.6)
Have you ever committed violence while under the influence of psychoactive substances?			0.14
Yes	42 (70.0)	18 (30.0)
No	38 (56.7)	29 (43.3)

	Types of violence n (%)
	Physical			Sexual			Psychological			Patrimonial			Others
	Yes	No	p-value^†	Yes	No	p-value^†	Yes	No	p-value^†	Yes	No	p-value^†	Yes	No	p-value^†
Tobacco			0.16			0.62			0.83			0.19			0.01
Problematic use	57 (62.0)	35 (38.0)		9 (9.8)	83 (90.2)		61(66.3)	31 (33.7)		39 (42.4)	53 (57.6)		5 (5.4)	87 (94.6)
Low risk/N.I.*	16 (50.0)	16 (50.0)		3 (9.4)	29 (90.6)		20(62.5)	12 (37.5)		6 (18.8)	26 (81.2)		7 (21.9)	25 (78.1)
Alcohol			0.04			0.80			0.10			0.005			0.19
Problematic use	55 (64.7)	30 (35.3)		8 (9.4)	77 (90.6)		60(70.6)	25 (29.4)		38 (44.7)	47 (53.3)		6 (7.1)	79 (92.9)
Low risk/N.I.*	18 (46.2)	21 (53.8)		4 (10.3)	35 (89.7)		21(53.8)	18 (46.2)		7 (17.9)	32 (55.3)		6 (15.4)	33 (84.6)
Marijuana			0.15			0.53			0.05			0.05			0.01
Problematic use	48 (63.2)	28 (36.8)		6 (7.9)	70 (92.1)		55(72.4)	21 (27.6)		33 (43.4)	43 (56.6)		3 (3.9)	73 (96.1)
Low risk/N.I.*	25 (52.1)	23 (47.9)		6 (12.5)	42 (87.5)		26(54.2)	22 (45.8)		12 (25.0)	36 (75.0)		9 (18.8)	39 (81.2)
Cocaine/Crack			0.06			1.00			0.25			0.44			0.07
Problematic use	48 (65.8)	25 (34.2)		7 (9.6)	66 (90.4)		51(69.9)	22 (30.1)		16 (31.4)	35 (68.6)		4 (5.5)	69 (94.5)
Low risk/N.I.*	25 (49.0)	26 (51.0)		5 (9.8)	46 (90.2)		30(58.8)	21 (41.2)		29 (30.7)	44 (60.3)		8 (15.7)	43 (84.3)
Amphetamines/Ecstasy			0.29			1.00			1.00			0.72			0.59
Problematic use	4 (44.4)	5 (55.6)		1 (11.1)	8 (88.9)		6 (66.7)	3 (33.3)		4 (44.4)	5 (55.6)		0 (0.0)	9 (100.0)
Low risk/N.I.*	68 (59.6)	46 (40.4)		11 (9.6)	103 (90.4)		74 (64.9)	40 (35.1)		41 (36.0)	73 (64.0)		12 (10.5)	102 (89.5)
Inhalants			0.52			0.21			1.00			1.00			0.21
Problematic use	11 (61.1)	7 (38.9)		0 (0.0)	18 (100.0)		12 (66.7)	6 (33.3)		6 (33.3)	12 (66.7)		0 (0.0)	18 (100.0)
Low risk/N.I.*	62 (58.5)	44 (41.5)		23 (9.8)	94 (88.7)		69 (65.1)	37 (34.9)		39 (36.8)	67 (63.2)		12 (11.3)	94 (88.7)
Hypnotics/Sedatives			0.09			1.00			0.14			0.25			1.00
Problematic use	6 (40.0)	9 (60.0)		1 (6.7)	14 (93.3)		7 (46.7)	8 (53.3)		3 (20.0)	12 (80.0)		1 (6.7)	14 (93.3)
Low risk/N.I.*	45 (55.6)	22 (27.2)		11(10.1)	98 (89.9)		74 (67.9)	35 (32.1)		42 (38.5)	67 (61.5)		11 (10.1)	98 (89.9)
Hallucinogens			0.56			0.56			1.00			1.00			1.00
Problematic use	5 (62.5)	3 (37.5)		1 (12.5)	7 (87.5)		5 (62.5)	3 (37.5)		3 (37.5)	5 (62.5)		0 (0.0)	8 (100.0)
Low risk/N.I.*	68 (58.6)	48 (41.4)		11 (9.5)	105 (90.5)		76 (65.5)	40 (34.5)		42 (36.2)	74 (63.8)		12 (10.3)	104 (89.7)
Opioids/Opiates			0.48			0.21			0.71			0.15			0.59
Problematic use	4 (44.4)	5 (55.6)		2 (22.2)	7 (77.8)		5 (55.6)	4 (44.4)		1 (11.1)	8 (88.9)		0 (0.0)	9 (100)
Low risk/N.I.*	69 (60.0)	46 (40.0)		10 (8.7)	105 (91.3)		76 (66.1)	39 (33.9)		44 (38.3)	71 (61.7)		12 (10.4)	103 (89.6)
Others			0.06			1.00			1.00			0.55			1.00
Problematic use	0 (0.0)	3 (100.0)		0 (0.0)	3 (100.0)		2 (66.7)	1 (33.3)		0 (0.0)	3 (100.0)		0 (0.0)	3 (100.0)
Low risk/N.I.*	73 (60.3)	48 (39.7)		12 (9.9)	109 (90.1)		79 (65.3)	42 (34.7)		45 (37.2)	76 (62.8)		12 (9.9)	109 (90.1)

Variables	Self-directed violence		p-value
	Yes	No
	n (%)	n (%)
Physical violence			0.048*
Yes	44 (60.3)	29 (39.7)
No	23 (42.6)	31 (57.4)
Sexual violence			0.033^†
Yes	10 (83.3)	2 (16.7)
No	57 (49.6 %)	58 (50.4)
Psychological violence			0.227*
Yes	46 (56.8)	35 (43.2)
No	21 (45.7)	25 (54.3)
Patrimonial violence			0.138^†
Yes	28 (62.2)	17 (37.8)
No	39 (47.6)	43 (52.4)
Other violence			1.000*
Yes	6 (50)	6 (50)
No	61 (53)	54 (47)
Mental distress			0.017^†
Yes	49 (61.3)	31 (38.8)
No	18 (38.3)	29 (61.7)
Tobacco			0.47^†
Problematic use	51 (54.3)	43 (45.7)
Low risk/No intervention	15 (46.9)	17 (53.1)
Alcohol			1.00^†
Problematic use	46 (52.9)	41 (47.1)
Low risk/No intervention	20 (51.3)	19 (48.7)
Marijuana			1.00^†
Problematic use	40 (51.9)	37 (48.1)
Low risk/No intervention	26 (53.1)	23 (46.9)
Cocaine/Crack			0.11^†
Problematic use	42 (56.8)	32 (43.2)
Low risk/No intervention	24 (46.2)	28 (53.8)
Amphetamines or Ecstasy			1.00^†
Problematic use	5 (50.0)	5 (50.0)
Low risk/No intervention	60 (52.2)	55 (47.8)
Inhalants			0.8^†
Problematic use	9 (47.4)	10 (52.6)
Low risk/No intervention	57 (53.3)	50 (45.7)
Hypnotics/Sedatives			0.59^†
Problematic use	9 (60.0)	6 (40.0)
Low risk/No intervention	57 (51.4)	54 (48.6)
Hallucinogens			0.38^†
Problematic use	3 (37.5)	5 (62.5)
Low risk/No intervention	63 (53.4)	55 (46.6)
Opioids/Opiates			0.73^†
Problematic use	4 (44.4)	5 (55.6)
Low risk/No intervention	62 (53.0)	55 (47.0)
Others			1.00^†
Problematic use	2 (50.0)	2 (50.0)
Low risk/No intervention	64 (52.5)	58 (47.5)

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[TFN1] *SD = standard deviation.