Neurocognition, psychiatric symptoms, and lifetime homelessness among veterans with a history of traumatic brain injury

•In Veterans with a TBI history, homelessness was linked to somewhat worse neurocognitive performance.•Homelessness was more strongly associated with substance use and unemployment.•Homelessness was not associated with TBI severity factors. We retrospectively investigated archival clinical data, including correlates of lifetime homelessness, in 503 Veterans with a history of traumatic brain injuries (86.5% mild) who completed neuropsychological evaluations and passed performance validity tests. The 471 never-homeless and 32 ever-homeless Veterans were compared on demographic factors, TBI severity, psychiatric diagnosis, subjective symptoms, and neuropsychological functioning. Homelessness history was significantly associated with unemployment, lower disability income, more severe depressive, anxiety, posttraumatic stress disorder, and postconcussive symptoms, and lower performances on two of fifteen neurocognitive tests. In a multiple logistic regression model, current unemployment and substance use disorder remained significantly associated with lifetime homelessness.