title: Social networks and support in first-episode psychosis: exploring the role of loneliness and anxiety.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors: 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.
authors: Oliver
authors: O
authors: Sündermann
authors: Juliana
authors: J
authors: Onwumere
authors: Fergus
authors: F
authors: Kane
authors: Craig
authors: C
authors: Morgan
authors: Elizabeth
authors: E
authors: Kuipers
mesh_terms: D000328:Adult; D000339:Affect; D001007:Anxiety / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010259:Paranoid Disorders / Q000150:complications / Q000523:psychology; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D057566:Self Report; D012944:Social Support
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