Social networks and clinical outcomes dually diagnosed homeless persons

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Longitudinal associations between social network characteristics and clinical outcomes were examined in a group of 130 homeless persons diagnosed with substance abuse and severe mental illness. Patients whose alcohol-use disorder remitted over 18 months had more frequent contact with Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) members at baseline, and those whose other substance use disorder remitted had fewer substance users in their baseline social networks. Smaller social networks predicted heavier alcohol use over time which, in turn, predicted attrition of abstinence supporters and decreased multiplexity of relationships. More frequent social contact predicted improved Expanded Brief Psychiatric Rating Scale (BPRS) symptoms. Improved BPRS symptoms and greater multiplexity of social relationships predicted each other over time. More severe BPRS symptoms and attrition of abstinence supporters predicted each other, but the mechanisms of this relationship and possible associations with alcohol or drug use remain to be tested. More severe BPRS symptoms also predicted later, proportional loss of professional contacts. Addiction Severity Index (ASI) drug use showed no longitudinal associations with social network characteristics.