{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T20:04:28Z","timestamp":1775160268691,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["3K12DA000357\u201022S1"],"award-info":[{"award-number":["3K12DA000357\u201022S1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Due to the complex interactions of psychopathology, psychosocial stressors, and risk behaviors, characterizing high\u2010risk phenotypic groups of transitional\u2010age youth experiencing homelessness (TAY\u2010EH) for targeted interventions remains difficult. We aimed to uncover specific phenotypes of TAY\u2010EH based upon psychiatric and substance use disorder (SUD) diagnoses, and to assess relationships between these phenotypes and negative outcomes including suicidality and high\u2010risk behaviors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants (<jats:italic>N<\/jats:italic>\u2009=\u2009140; 57% male, 54% Black) were individuals aged 16\u201325 years accessing support at a psychosocial agency in the U.S. Northeast. Data were gathered via structured assessment. Cluster analysis identified sub\u2010groups of TAY\u2010EH with differing diagnostic patterns. Bivariate analyses examined associations between cluster membership and target outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A four\u2010cluster solution was identified. Cluster 1 (<jats:italic>Co\u2010occurring<\/jats:italic>; <jats:italic>N<\/jats:italic>\u2009=\u200933) was characterized by high levels of comorbidity (i.e., major depressive disorder (MDD), SUD, and notable levels of other diagnoses). Clusters 2 (<jats:italic>MDD alone<\/jats:italic>; <jats:italic>N<\/jats:italic>\u2009=\u200947) and 3 (<jats:italic>SUD alone<\/jats:italic>; <jats:italic>N<\/jats:italic>\u2009=\u200918) were characterized by single diagnoses. Cluster 4 (<jats:italic>None<\/jats:italic>; <jats:italic>N<\/jats:italic>\u2009=\u200942) was characterized by low levels of psychopathology. Clusters differed significantly on several variables including suicidality, adverse childhood experiences, and social connectedness. Comorbid MDD and SUD were most strongly associated with high\u2010risk behaviors and suicidality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>These results highlight the importance of diagnosis and targeted interventions for co\u2010occurring MDD and SUD to address the crisis of early mortality and other negative outcomes among TAY\u2010EH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>This study is the first to identify specific high\u2010risk psychiatric and psychosocial phenotypes among the highly complex group of TAY\u2010EH based upon structured diagnostic assessments.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13655","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T04:14:38Z","timestamp":1728620078000},"page":"305-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Substance use and psychiatric phenotypes of youth experiencing homelessness: A cluster analysis"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8658-2632","authenticated-orcid":false,"given":"Colin W.","family":"Burke","sequence":"first","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital 55 Fruit Street Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0409-7343","authenticated-orcid":false,"given":"Sylvia","family":"Lanni","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital 55 Fruit Street Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina B.","family":"Hoeppner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital 55 Fruit Street Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Ducharme","sequence":"additional","affiliation":[{"name":"Bridge Over Troubled Waters 47 West Street Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy E.","family":"Wilens","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital 55 Fruit Street Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.10.006"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaacop.2023.01.001"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajad.13340"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-4302"},{"key":"e_1_2_9_6_1","volume-title":"The heterogeneity of homeless youth in America: Examining typologies. 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