Social support and psychopathology in homeless patients presenting for emergency psychiatric treatment

We compared homeless to domiciled psychiatric patients' symptomatology and perceived level of social support (PSS) within hours of psychiatric emergency service (PES) arrival. Homeless patients experienced less PSS and more negative symptoms, but not more psychosis, than their domiciled counterparts. Domiciled patients' PSS was highly related to their clinical presentation: less support predicted increased psychopathology. Homeless patients' clinical symptoms, although as common and severe, were unassociated with PSS. These findings suggest that homeless psychiatric patients may be less reactive to positive environmental influences like social support and manifest more severe and refractory symptoms than domiciled patients presenting for emergency treatment.