title: The impact of psychosis on social inclusion and associated factors.
abstract: BACKGROUND
  People with mental health problems are known to be socially excluded but the contribution of pre-morbid characteristics, symptoms and needs, and the impact on quality of life is unknown.
  
  
  OBJECTIVE
  To investigate change in social inclusion after the development of a psychotic Illness and factors associated with this.
  
  
  METHODS
  A cross-sectional community survey of people with psychosis was carried out in three areas of London. Five domains of social inclusion (social integration, consumption, access to services, productivity, political engagement) were assessed prior to the onset of illness and currently using the Social Inclusion Questionnaire User Experience. Quality of life, symptoms and needs were also assessed using standardized measures. Factors associated with change in social inclusion were investigated using multiple regression.
  
  
  RESULTS
  Productivity and social integration among the 67 participants reduced after the onset of psychosis. Older age at onset and longer duration of illness were associated with greater reduction in productivity. Less reduction in social integration was associated with greater quality of life. Participants reported barriers to social inclusion that were directly related to symptoms of their illness, low confidence and poor self-esteem.
  
  
  CONCLUSIONS
  A greater focus on interventions that can facilitate the occupation and the social networks of people with psychosis is required. Interventions that tackle 'self-stigma' may also prove useful in mitigating the social exclusion experienced by people with psychosis.
authors: 1University College London, UK.
authors: Helen
authors: H
authors: Killaspy
authors: Sarah
authors: S
authors: White
authors: Nabeela
authors: N
authors: Lalvani
authors: Rachel
authors: R
authors: Berg
authors: Ajoy
authors: A
authors: Thachil
authors: Sen
authors: S
authors: Kallumpuram
authors: Omar
authors: O
authors: Nasiruddin
authors: Christine
authors: C
authors: Wright
authors: Gill
authors: G
authors: Mezey
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D012929:Psychological Distance; D011618:Psychotic Disorders / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Psychosis; social inclusion
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