Hostname: page-component-745bb68f8f-5r2nc Total loading time: 0 Render date: 2025-01-11T00:42:04.313Z Has data issue: false hasContentIssue false
  • English
  • Français

Social networks, support and early psychosis: a systematic review

Part of: Special Articles

Published online by Cambridge University Press:  26 July 2012

C. Gayer-Anderson  and
C. Morgan
C. Gayer-Anderson*
Affiliation:
Section of Social Psychiatry, Institute of Psychiatry, King's College London, London, England
C. Morgan
Affiliation:
Section of Social Psychiatry, Institute of Psychiatry, King's College London, London, England
*
*Address for correspondence: Charlotte Gayer-Anderson, PhD, Box 33, Section of Social Psychiatry, Health Service and Population Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, England. (Email: charlotte.gayer-anderson@kcl.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

There is strong evidence that those with a long-standing psychotic disorder have fewer social contacts and less social support than comparison groups. There is less research on the extent of social contacts and support prior to or at the onset of psychosis. In the light of recent evidence implicating a range of social experiences and contexts at the onset of psychosis, it is relevant to establish whether social networks and support diminished before or at the time of onset and whether the absence of such supports might contribute to risk, either directly or indirectly. We, therefore, conducted a systematic review of this literature to establish what is currently known about the relationship between social networks, support and early psychosis.

Methods.

We identified all studies investigating social networks and support in first episode psychosis samples and in general population samples with measures of psychotic experiences or schizotype by conducting systematic searches of electronic databases using pre-defined search terms and criteria. Findings were synthesized using non-quantitative approaches.

Results.

Thirty-eight papers were identified that met inclusion criteria. There was marked methodological heterogeneity, which limits the capacity to draw direct comparisons. Nonetheless, the existing literature suggests social networks (particularly close friends) and support diminished both among first episode samples and among non-clinical samples reporting psychotic experiences or with schizotype traits, compared with varying comparison groups. These differences may be more marked for men and for those from minority ethnic populations.

Conclusions.

Tentatively, reduced social networks and support appear to pre-date onset of psychotic disorder. However, the substantial methodological heterogeneity among the existing studies makes comparisons difficult and suggests a need for more robust and comparable studies on networks, support and early psychosis.

Keywords

Onsetpsychosissocial networksocial support
Type
Special Article
Information
Epidemiology and Psychiatric Sciences , Volume 22 , Issue 2 , June 2013 , pp. 131 - 146
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alptekin, K, Ulas, H, Akdede, BB, Tumuklu, M, Akvardar, Y (2009). Prevalence and risk factors of psychotic symptoms: in the city of Izmir, Turkey. Social Psychiatry and Psychiatric Epidemiology 44, 905–910.CrossRefGoogle ScholarPubMed
Beels, CC (1981). Social support and schizophrenia. Schizophrenia Bulletin 7, 58–72.CrossRefGoogle ScholarPubMed
Beels, CC, Gutwirth, L, Berkeley, J, Struening, E (1984). Measurements of social support in schizophrenia. Schizophrenia Bulletin 10, 399–411.Google Scholar
Blanchard, JJ, Collins, LM, Aghevli, M, Leung, WW, Cohen, AS (2011). Social anhedonia and schizotypy in a community sample: The Maryland Longitudinal Study of Schizotypy. Schizophrenia Bulletin 37, 587–602.Google Scholar
Brugha, T, Jenkins, R, Bebbington, P, Meltzer, H, Lewis, G, Farrell, M (2004). Risk factors and the prevalence of neurosis and psychosis in ethnic groups in Great Britain. Social Psychiatry and Psychiatric Epidemiology 39, 939–946.Google Scholar
Brugha, TS (2010). Social support. In Principles of Social Psychiatry, 2nd edn (ed. Morgan, C. and Bhugra, D.), pp. 461–476. Wiley–Blackwell: Oxford.CrossRefGoogle Scholar
Brugha, TS, Sturt, E, MacCarthy, B, Potter, J, Wykes, T, Bebbington, P (1987). The interview measure of social relationships: the description and evaluation of a survey instrument for assessing personal social resources. Social Psychiatry 22, 123–128.Google Scholar
Buchanan, J (2004). Social support and schizophrenia: a review of the literature. Archives of Psychiatric Nursing 9, 68–76.Google Scholar
Chakraborty, AT, McKenzie, KJ, Hajat, S, Stansfeld, SA (2010). Racism, mental illness and social support in the UK. Social Psychiatry and Psychiatric Epidemiology 45, 1115–1124.CrossRefGoogle ScholarPubMed
Cohen, C, Sokolovsky, J (1979). Schizophrenia and social networks. Schizophrenia Bulletin 4, 546–560.Google Scholar
Cohen, S, Mermelstein, R, Kamarck, T, Hoberman, HM (1985). Measuring the functional components of social support. In Social Support: Theory, Research, and Applications (ed. Sarason, IG and Sarason, BR), pp. 73–94. Martinus Nijhoff: Dordrecht, The Netherlands.Google Scholar
Cox, BD, Blaxter, M, Buckle, ALJ, Fenner, NP, Golding, JF, Gore, M, Hupper, FA, Nickson, J, Roth, M, Stark, J, Wadsworth, MEJ, Wichelow, M (1987). The Health and Lifestyle Survey. Health Promotion Research Trust: London.Google Scholar
Dangelmaier, RE, Docherty, NM, Akamatsu, T (2006). Psychosis proneness, coping, and perceptions of social support. American Journal of Orthopsychiatry 76, 13–17.Google Scholar
Das-Munshi, J, Becares, L, Boydell, JE, Dewey, ME, Morgan, C, Stansfeld, SA, Prince, MJ (in press). Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC). British Journal of Psychiatry.Google Scholar
Dunn, M, O'Driscoll, C, Dayson, D, Wills, W, Leff, J (1990). The TAPS Project 4: an observational study of the social life of long-stay patients. British Journal of Psychiatry 157, 842–848, 852.Google Scholar
Erickson, DH, Beiser, M, Iacono, WG, Fleming, JA, Lin, TY (1989). The role of social relationships in the course of first-episode schizophrenia and affective psychosis. American Journal of Psychiatry 146, 1456–1461.Google Scholar
Fearon, P, Morgan, C (2006). Environmental factors in schizophrenia: the role of migrant studies. Schizophrenia Bulletin 32, 405–408.Google Scholar
Flyckt, L, Mattsson, M, Edman, G, Carlsson, R, Cullberg, J (2006). Predicting 5-year outcome in first-episode psychosis: construction of a prognostic rating scale. Journal of Clinical Psychiatry 67, 916–924.Google Scholar
Freeman, D, Gittins, M, Pugh, K, Antley, A, Slater, M, Dunn, G (2008 a). What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences 38, 1121–1132.Google Scholar
Freeman, D, Pugh, K, Antley, A, Slater, M, Slater, M, Bebbington, P, Gittens, M, Dunn, G, Kuipers, E, Fowler, D, Garety, P (2008 b). Virtual reality study of paranoid thinking in the general population. British Journal of Psychiatry, 192, 258–263.CrossRefGoogle ScholarPubMed
Freeman, D, Pugh, K, Garety, P (2008 c). Jumping to conclusions and paranoid ideation in the general population. Schizophrenia Research, 102, 254–260.Google Scholar
Freeman, D, McManus, S, Brugha, T, Meltzer, H, Jenkins, R, Bebbington, P (2011). Concomitants of paranoia in the general population. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences 41, 923–936.Google Scholar
Harris, T, Brown, GW, Robinson, R (1999 a). Befriending as an intervention for chronic depression among women in an inner city. 1: Randomised controlled trial. British Journal of Psychiatry 174, 219–224.CrossRefGoogle Scholar
Harris, T, Brown, GW, Robinson, R (1999 b). Befriending as an intervention for chronic depression among women in an inner city. 2: Role of fresh-start experiences and baseline psychosocial factors in remission from depression. British Journal of Psychiatry 174, 225–232.CrossRefGoogle Scholar
Heller, K, Swindle, RW, Dusenbury, L (1986). Component social support processes: comments and integration. Journal of Consulting and Clinical Psychology 54, 466–470.Google Scholar
Henderson, S, Duncan-Jones, P, McAuley, H, Ritchie, K (1978). The patient's primary group. British Journal of Psychiatry 132, 74–86.Google Scholar
Hodges, A, Byrne, M, Grant, E, Johnstone, E (1999). People at risk of schizophrenia. Sample characteristics of the first 100 cases in the Edinburgh High-Risk Study. British Journal of Psychiatry 174, 547–553.Google Scholar
Horan, WP, Subotnik, KL, Snyder, KS, Nuechterlein, KH (2006). Do recent-onset schizophrenia patients experience a “social network crisis”? Psychiatry 69, 115–129.CrossRefGoogle ScholarPubMed
Horan, WP, Brown, SA, Blanchard, JJ (2007). Social anhedonia and schizotypy: the contribution of individual differences in affective traits, stress, and coping. Psychiatry Research 149, 147–156.Google Scholar
Isele, R, Merz, J, Malzacher, M, Angst, J (1985). Social disability in schizophrenia: the controlled prospective Burgholzli study II. Premorbid living situation and social adjustment – comparison with a normal control sample. European Archives of Psychiatry and Neurological Sciences 234, 348–356.Google Scholar
Jackson, HJ, McGorry, PD, Dudgeon, P (1995). Prodromal symptoms of schizophrenia in first-episode psychosis: prevalence and specificity. Comprehensive Psychiatry 36, 241–250.Google Scholar
Jenkins, R, Mbatia, J, Singleton, N, White, B (2010). Prevalence of psychotic symptoms and their risk factors in urban Tanzania. International Journal of Environmental Research and Public Health [Electronic Resource] 7, 2514–2525.Google Scholar
Jeppesen, P, Petersen, L, Thorup, A, Abel, M, Ohlenschlaeger, J, Christensen, T, Krarup, G, Jorgensen, P, Nordentoft, M (2008). The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences 38, 1157–1166.Google Scholar
Kalla, O, Aaltonen, J, Wahlstrom, J, Lehtinen, V, Garcia Cabeza, I, Gonzalez de Chavez, M (2002). Duration of untreated psychosis and its correlates first-episode psychosis in Finland and Spain. Acta Psychiatrica Scandinavica 106, 265–275.Google Scholar
Lipton, FR, Cohen, CI, Fischer, E, Katz, SE (1981). Schizophrenia: a network crisis. Schizophrenia Bulletin 7, 144–151.Google Scholar
Macdonald, E, Madden, C, Roods, G (1996). The adolescent social relationship scale: a scale to measure social support in young people. Unpublished manuscript, La Trobe Univeristy, Melbourne, Australia.Google Scholar
Macdonald, E, Hayes, R, Baglioni, A (2000). The quantity and quality of the social networks of young people with early psychosis compared with closely matched controls. Schizophrenia Research 46, 25–30.Google Scholar
Mallett, R, Leff, J, Bhugra, D, Pang, D, Zhao, JH (2002). Social environment, ethnicity and schizophrenia. Social Psychiatry and Psychiatric Epidemiology 37, 329–335.CrossRefGoogle ScholarPubMed
Mays, N, Roberts, E, Popay, J (2001). Synthesising research evidence. In Studying the Organisation and Delivery of Health Services: Research Methods (ed. Fulop, N., Allen, P., Clarke, A. and Black, N.), pp. 188–220. Routledge: London.Google Scholar
Morgan, C, Kirkbride, J, Hutchingson, G, Craig, TK, Morgan, K, Dazzan, P, Boydell, J, Doddy, GA, Jones, PB, Murray, RM, Leff, J, Fearon, P (2008). Cumulative social disadvantage, ethnicity and first-episode psychosis: a case-control study. Psychological Medicine 38, 1701–1715.Google Scholar
Morgan, C, Fisher, H, Hutchinson, G, Kirkbride, J, Craig, TK, Morgan, K, Dazzan, P, Boydell, J, Doody, GA, Jones, PB, Murray, RM, Leff, J, Fearon, P (2009). Ethnicity, social disadvantage and psychotic-like experiences in a healthy population based sample. Acta Psychiatrica Scandinavica 119, 226–235.Google Scholar
Morgan, C, Charalambides, M, Hutchinson, G, Murray, R (2010). Migration, ethnicity and psychosis: toward a socio-developmental model. Schizophrenia Bulletin 36, 655–664.Google Scholar
O'Brien, MP, Gordon, JL, Bearden, CE, Lopez, SR, Kopelowicz, A, Cannon, TD (2006). Positive family environment predicts improvement in symptoms and social functioning among adolescents at imminent risk for onset of psychosis. Schizophrenia Research 81, 269–275.Google Scholar
Peralta, V, Cuesta, MJ, Martinez-Larrea, A, Serrano, JF, Langarica, M (2005). Duration of untreated psychotic illness: the role of premorbid social support networks. Social Psychiatry and Psychiatric Epidemiology 40, 345–349.Google Scholar
Procidano, ME, Heller, K (1983). Measures of perceived social support from friends and from family: three validation studies. American Journal of Community Psychology, 11, 1–24.CrossRefGoogle ScholarPubMed
Pruessner, M, Iyer, SN, Faridi, K, Joober, R, Malla, AK (2011). Stress and protective factors in individuals at ultra-high risk for psychosis, first episode psychosis and healthy controls. Schizophrenia Research 129, 29–35.Google Scholar
Rabinovitch, M, Bechard-Evans, L, Schmitz, N, Joober, R, Malla, A (2009). Early predictors of nonadherence to antipsychotic therapy in first-episode psychosis. Canadian Journal of Psychiatry – Revue Canadienne de Psychiatrie 54, 28–35.Google Scholar
Reininghaus, UA, Morgan, C, Simpson, J, Dazzan, P, Morgan, K, Doody, GA, Bhugra, D, Leff, J, Murray, R, Fearon, P, Craig, TK (2008). Unemployment, social isolation, achievement-expectation mismatch and psychosis: findings from the AESOP study. Social Psychiatry and Psychiatric Epidemiology 43, 743–751.Google Scholar
Salokangas, RK (1996). Living situation and social network in schizophrenia – a prospective 5-year follow-up study. Nordic Journal of Psychiatry 50, 35–42.CrossRefGoogle Scholar
Salokangas, RK (1997). Living situation, social network and outcome in schizophrenia: a five-year prospective follow-up study. Acta Psychiatrica Scandinavica 96, 459–468.Google Scholar
Sarason, IG, Levine, HM, Basham, RB, Sarason, BR (1983). Assessing social support: the social support questionnaire. Journal of Personality and Social Psychiatry 44, 127–139.Google Scholar
Schuldberg, D, Karwacki, SB, Burns, GL (1996). Stress, coping, and social support in hypothetically psychosis-prone subjects. Psychological Reports 78, 1267–1283.CrossRefGoogle ScholarPubMed
Schuschter, TL, Kessler, RC, Aseltine, RH (1990). Supportive interactions, negative interactions, and depressed mood. American Journal of Community Psychology 18, 423–438.Google Scholar
Song, YY, Kim, KR, Park, JY, Lee, SY, Kang, JI, Lee, E, An, SK, Kwon, JS (2011). Associated factors of quality of life in first-episode schizophrenia patients. Psychiatry Investigation 8, 201–206.Google Scholar
Stansfeld, SA, Marmot, MG (1992). Deriving a survey measure of social support: the reliability and validity of the close persons questionnaire. Social Science and Medicine 35, 1027–1035.Google Scholar
Sturtees, PG (1980). Social support, residual adversity and depressive outcome. British Journal of Psychiatry 15, 71–80.Google Scholar
Susser, E, Scwartz, S, Morabia, A, Bromet, EJ (2006). Psychiatric Epidemiology: Searching for the Causes of Mental Disorder. Oxford University Press: Oxford.Google Scholar
Taylor, SE, Aspinwall, LG (1996). Mediating and moderating processes in psychosocial stress: Appraisal, coping, resistance and vulnerability. In Psychosocial stress: Perspectives on Structure, Theory, Life Course, and Methods. (ed. Kaplan, HB), pp. 71–110. Academic Press: San Diego.Google Scholar
Thoits, P (1982). Conceptual, methodological, and theoretical problems in studying social support as a buffer against life stress. Journal of Health and Social Behaviour 23, 145–159.Google Scholar
Thorup, A, Petersen, L, Jeppesen, P, Ohlenschlaeger, J, Christensen, T, Krarup, G, Jorgensen, P, Nordentoft, M (2006). Social network among young adults with first-episode schizophrenia spectrum disorders: results from the Danish OPUS trial. Social Psychiatry and Psychiatric Epidemiology 41, 761–770.CrossRefGoogle ScholarPubMed
Thorup, A, Petersen, L, Jeppesen, P, Ohlenschlaeger, J, Christensen, T, Krarup, G, Jorgensen, P, Nordentoft, M (2007). Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study. Journal of Nervous and Mental Disease 195, 396–405.Google Scholar
Tolsdorf, CC (1976). Social networks, support, and coping: an exploratory study. Family Process 15, 407–417.CrossRefGoogle ScholarPubMed
Turner, RJ, Brown, RL (2010). Social support and mental health. In A Handbook for the Study of Mental Health: Social Contexts, Theories and Systems, 2nd edn (ed. Scheid, TL and Brown, TN), pp. 200–212. Cambridge University Press: Cambridge.Google Scholar
Uzenoff, SR, Brewer, KC, Perkins, DO, Johnson, DP, Mueser, KT, Penn, DL (2010). Psychological well-being among individuals with first-episode psychosis. Early Intervention in Psychiatry 4, 174–181.Google Scholar
Van Eijk, LM, van Kempen, GIJM, van Sonderen, FLP (1994). A short scale measuring social support in the elderly: the SSL12-I. Tijdschrift Voor Gerontologie en Geriatrie 25, 192–196.Google Scholar
van Os, J, Kenis, G, Rutten, B (2010). The environment and schizophrenia. Nature 468, 203–212.CrossRefGoogle ScholarPubMed
Veling, W, Hoek, HW, Wiersma, D, Mackenbach, JP (2010). Ethnic identity and the risk of schizophrenia in ethnic minorities: a case-control study. Schizophrenia Bulletin 36, 1149–1156.Google Scholar
Warr, P (1987). Work, Unemployment and Mental Health. Clarendon Press: Oxford.Google Scholar
Wiles, NJ, Zammit, S, Bebbington, P, Singleton, N, Meltzer, H, Lewis, G (2006). Self-reported psychotic symptoms in the general population: results from the longitudinal study of the British National Psychiatric Morbidity Survey. British Journal of Psychiatry 188, 519–526.Google Scholar
Willhite, RK, Niendam, TA, Bearden, CE, Zinberg, J, O'Brien, MP, Cannon, TD (2008). Gender differences in symptoms, functioning and social support in patients at ultra-high risk for developing a psychotic disorder. Schizophrenia Research 104, 237–245.Google Scholar
Zimet, GD, Dahlem, NW, Zimet, SG, Farley, GK (1988). The multidimensional scale of perceived social support. Journal of Personal Assessment 52, 30–41.Google Scholar