title: Friends and symptom dimensions in patients with psychosis: a pooled analysis.
abstract: BACKGROUND
  Having friends is associated with more favourable clinical outcomes and a higher quality of life in mental disorders. Patients with schizophrenia have fewer friends than other mentally ill patients. No large scale studies have evaluated so far what symptom dimensions of schizophrenia are associated with the lack of friendships.
  
  
  METHODS
  Data from four multi-centre studies on outpatients with schizophrenia and related disorders (ICD F20-29) were included in a pooled analysis (N = 1396). We established whether patients had close friends and contact with friends by using the equivalent items on friendships of the Manchester Short Assessment of Quality of Life or of the Lancashire Quality of Life Profile. Symptoms were measured by the Brief Psychiatric Rating Scale or by the identical items included in the Positive and Negative Syndrome Scale.
  
  
  RESULTS
  Seven hundred and sixty-nine patients (55.1%) had seen a friend in the previous week and 917 (65.7%) had someone they regarded as a close friend. Low levels of negative symptoms and hostility were significantly associated with having a close friend and contact with a friend. Overall, almost twice as many patients with absent or mild negative symptoms had met a friend in the last week, compared with those with moderate negative symptoms.
  
  
  CONCLUSIONS
  Higher levels of negative symptoms and hostility are specifically associated with the lack of friendships in patients with psychotic disorders. These findings suggest the importance of developing effective treatments for negative symptoms and hostility in order to improve the probability of patients with schizophrenia to have friends.
authors.affiliation: Unit for Social and Community Psychiatry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom. d.giacco@qmul.ac.uk
authors.forename: Domenico
authors.initials: D
authors.lastname: Giacco
authors.forename: Rose
authors.initials: R
authors.lastname: McCabe
authors.forename: Thomas
authors.initials: T
authors.lastname: Kallert
authors.forename: Lars
authors.initials: L
authors.lastname: Hansson
authors.forename: Andrea
authors.initials: A
authors.lastname: Fiorillo
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D005260:Female; D033062:Friends / Q000523:psychology*; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis / Q000503:physiopathology*; D011788:Quality of Life; D012559:Schizophrenia / Q000175:diagnosis / Q000503:physiopathology*; D012565:Schizophrenic Psychology