Social networks of patients with psychosis: a systematic review

Claudia Palumbo, Umberto Volpe, Aleksandra Matanov, Stefan Priebe, Domenico Giacco

Social networks are important for mental health outcomes as they can mobilise resources and help individuals to cope with social stressors. Individuals with psychosis may have specific difficulties in establishing and maintaining social relationships which impacts on their well-being and quality of life. There has been a growing interest in developing social network interventions for patients with psychotic disorders. A systematic literature review was conducted to investigate the size of social networks of patients with psychotic disorders, as well as their friendship networks. A systematic electronic search was carried out in MEDLINE, EMBASE and PsychINFO databases using a combination of search terms relating to 'social network', 'friendship' and 'psychotic disorder'. The search identified 23 relevant papers. Out of them, 20 reported patient social network size. Four papers reported the mean number of friends in addition to whole network size, while three further papers focused exclusively on the number of friends. Findings varied substantially across the studies, with a weighted mean size of 11.7 individuals for whole social networks and 3.4 individuals for friendship networks. On average, 43.1 % of the whole social network was composed of family members, while friends accounted for 26.5 %. Studies assessing whole social network size and friendship networks of people with psychosis are difficult to compare as different concepts and methods of assessment were applied. The extent of the overlap between different social roles assessed in the networks was not always clear. Greater conceptual and methodological clarity is needed in order to help the development of effective strategies to increase social resources of patients with psychosis.