Social networks and support in first-episode psychosis: exploring the role of loneliness and anxiety

Abstract

PURPOSE-To investigate social support and network features in people with first episode psychosis, and to examine anxiety as a possible mediator between loneliness and a rating of paranoia.METHOD-Thirty eight people with first-episode psychosis were recruited for a cross-sectional study. Self report questionnaires and structured interviews assessed symptoms, functioning, and qualitative social network and support features. A mood-induction task involved watching anxiety-inducing pictures on a computer screen. Visual analogue scales assessed changes in paranoia, anxiety and loneliness and a mediation analysis was conducted.RESULTS-One third of the sample (34%) had no confidant (95% CI 18.4%, 50.0%). The average number of weekly contacts was 3.9, with 2.6 lonely days. Poor perceived social support, loneliness and the absence of a confidant were strongly associated with psychosis and depressive symptoms (.35<r's<.60). The association between loneliness and paranoia was mediated through anxiety (ab=.43, z=3.5; p<.001).CONCLUSIONS-Even at first episode, a large proportion of people with psychosis have poor perceived support, no confidant and report several lonely days a week. Patients without a confidant appear to be more susceptible to feeling lonely and anxious. Anxiety may be one pathway through which loneliness affects psychosis. Interventions which focus on this are indicated.

Social relationships in young adults at ultra high risk for psychosis

“…In a sample of Swedish army members, premorbid assessments showed that preferring to socialize in small groups, having fewer than two friends, and not having a girlfriend were associated with an increased risk of developing schizophrenia (Malmberg et al, 1998). Another study of individuals with first episode psychosis found that many individuals reported poor perceived social support and feeling lonely several days a week (Sündermann et al, 2014). Many of these individuals did not have even one confidant, which was associated with being more susceptible to loneliness.…”

“…Specifically, the study aimed to evaluate potential differences between UHR individuals and controls in number of close friends, social network diversity, perceived social support, quality of relationships with family and friends, and loneliness. Based on findings from past studies of individuals with psychosis, we hypothesized that compared to healthy controls, UHR participants would report significantly fewer close friends (Dickey et al, 2005), less social network diversity (Goldberg et al, 2003), less perceived social support (Pruessner et al, 2011), poorer quality relationships with family and friends (Cohen and Iii, 2009), and more loneliness (Sündermann et al, 2014). …”

Girls get by with a little help from their friends: gender differences in protective effects of social support for psychotic phenomena amongst poly-victimised adolescents

“…Conversely, increased levels of perceived social support have been linked to an absence of psychotic experiences amongst adolescents at high risk due to exposure to multiple forms of victimisation (poly-victimised) [4]. Research has suggested that social support may buffer the effects of stress [5–8], improve self-esteem [9–11], and reduce feelings of loneliness [12,13], which may all protect against psychotic phenomena.…”

Understanding the experience of women admitted to a psychiatric hospital in Sydney with psychosis or mania following childbirth after World War II (1945–1955)

“…; Sündermann et al . ). She was admitted to the Darlinghurst Reception House 4 weeks before the birth of the child because she was reported as being dull and disinterested, emotional, and destructive, and was treated with sedation.…”