Social networks and support in first-episode psychosis: exploring the role of loneliness and anxiety
Social networks and support in first-episode psychosis: exploring the role of loneliness and anxiety
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DOI：
10.1007/s00127-013-0754-3
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发表时间：
2014-03-01
影响因子：
4.4
通讯作者：
Kuipers, Elizabeth
中科院分区：
文献类型：
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作者：
Suendermann, Oliver;Onwumere, Juliana;Kuipers, Elizabeth
目的探讨首发精神病患者的社会支持和网络特征，并探讨焦虑在孤独和偏执评分之间的可能中介作用。方法对38例首发精神病患者进行横断面研究。自我报告问卷和结构化访谈评估了症状、功能和定性的社会网络和支持特征。一项情绪诱导任务是在电脑屏幕上观看引起焦虑的图片。视觉模拟量表评估偏执、焦虑和孤独的变化，并进行中介分析。结果三分之一（34%）的患者没有知己[95% CI(18.4, 50.0%)]。每周的平均联系次数为3.9次，其中有2.6天是孤独的。感知社会支持差、孤独和缺乏知己与精神病和抑郁症状密切相关（0.35 < rs < 0.60）。孤独和偏执之间的关联通过焦虑介导（ab = 0.43, z = 3.5; p < 0.001）。结论：即使在首次发作时，很大一部分精神病患者也缺乏感知支持，没有知己，每周有几天感到孤独。没有知己的病人似乎更容易感到孤独和焦虑。焦虑可能是孤独影响精神病的一个途径。指出了着重于此的干预措施。
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.