Citation

Sündermann O, Onwumere J, Kane F, Morgan C, Kuipers E. Soc. Psychiatry Psychiatr. Epidemiol. 2014; 49(3): 359-366.

Affiliation

South London Maudsely NHS Foundation Trust, Anxiety Disorders Residential Unit, Bethlem Royal Hospital, Monks Orchard Road, London, BR3 3BX, UK, oliver.suendermann@kcl.ac.uk.

Copyright

(Copyright © 2014, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00127-013-0754-3

PMID

23955376

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 (0.35 < rs < 0.60). The association between loneliness and paranoia was mediated through anxiety (ab = 0.43, z = 3.5; p < 0.001). 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.

Language: en