Long-Term Social Supports Needed After Onset of Psychosis

Justin Karter
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New data on the effects of social support after the onset of psychosis suggests that patients with intense social support function better than those without such help, but than once supports are removed the effects eventually diminish.

These findings revealed this week by Joseph P. McEvoy at the 28th US Psychiatric and Mental Health Congress being held this week in San Diego, according to the American Journal of Managed Care (AJMC).

McEvoy began research ten years ago into prevention programs for those at risk of psychosis and found that connecting patients with their families and friends “can pay dividends.” His focus has now shifted toward examining how social supports can be leveraged to prevent progression to psychosis.

His research, collected over ten years from 5 different countries, indicates that patients who had intense social support for the first 2-3 years “functioned far better than those who lacked such help.”  When the social support programs ended, however, the differences between these two groups diminished and, after ten years had passed, the two groups were “indistinguishable.”

“The best help for young adults who have had an episode,” McEvoy said, “is to reintegrate them with other people.”  According to AJMC, McEvoy “showed a slide of an amputee whose prosthetic leg had been taken away,” then asked: “Would anyone expect that person to be able to run?”

McEvoy also presented his research on the effects of polyunsaturated fatty acids used in early intervention psychosis programs, according to AJMC.

To see MIAs coverage of recent research on the use of omega-3 fatty acids in first episode psychosis click here→

 

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12 COMMENTS

  1. Here are typical disease-model distortions straight out of the actual article:

    “Psychotic disorders are bad diseases.”

    “Much work has been done in the past decade to understand the relationship to dopamine dysregulation; which McEvoy said, “underlies the onset of psychosis.”

    “Psychosis has genetic components…”

    “(because) there are no biomarkers… this makes intervention tricky, because antipsychotic treatments have serious side effects and should not be given without cause.”

    In other words, this doctor McEvoy understands very little about people with “psychosis”, if he assumedly thinks that antipsychotics should be a front line “treatment”, and that psychosis is a “disease” with genetic components. How pathetic.

    This is just another example of a researcher who can see some fragments of the what these poor people need, like the blatantly obvious fact that social support helps, but completely misunderstands the nature of these individuals’ distress as a “disease” with genetic components.

    Isn’t it time to curtail the posting of these tired, distorted articles on MIA?

    And if people with social support function better than people without, I have other shocking news: Water makes things wet, stubbing your toe hurts, and covering things with green paint makes them look green.

    • I wonder if in his research he looked if there is any influence of the drugs in how people respond to social support and how long it’s positive effects persist in those on and off the drugs. Anti-psychotics blunt affect and change cognition so I’d expect people to be less responsive to social environment when they take them and to be less resistant to losing such support as well. I wonder if they did it or if they even allowed anyone to go “untreated”. If the social support is all about reminding you to take a pill then no wonder that the effects don’t last.

      The problem with all these studies is that there’s no real control group. People are never allowed to go without “treatment” because it’s assumed, with no good evidence and plenty to the contrary, that they need it and it would be unethical to spare them the drugging. And then the psychiatry proponents can turn around and scream “correlation’s not causation” while doing an actual experiment to prove causation would not be allowed.

      “young adults may resist treatment due to the side effects: would you, he asked, want to gain 30 pounds or experience sexual dysfunction? ”
      Young adults may also resist “treatment” because of the EFFECTS – turning into a drooling zombie, which is the primary way these drugs “works”.

      • I see both sides of this issue. While it’s lamentable that people are put on antipsychotics, as I was for ten years (and was just forced to start them again when I couldn’t find a social support system like Soteria or Open Dialogue), I will say openly that I had great social support from my family and that it was indeed crucial. Without it, I would have been lost. I wish we didn’t have a system that forces us down the drug route, and I wish it was ALL socially based. That is what matters most to me and what I try to do with my time: give support to others around me. Even in a small town like my own, there are numerous individuals who need help on a daily basis, whether it’s something as simple as taking the time to talk to them, or taking the time and a little money to get someone a bottle of Benadryl so that when the antipsychotics akithisia (the tension and the shakes) gets too bad they can relax a little. At least this doctor — I wish we didn’t have to deal with them at all, but while we have to — is willing to look at something a little more than just the drugs. If we can start with people like that, maybe we can move the system back to where it used to be, where there were no drugs at all.

        • Eric, sorry to hear about these challenges you’ve faced due to the utter inadequacy of our social support systems for people dealing with psychosis.

          Giving help to other people around you is so healing and something never focused on when you read professional reports about “managing schizophrenia.” Receiving and later giving love offer the only real escape from psychosis / severe psychic suffering.

          Luckily when I was pressured to take psychiatric drugs for a period years ago, I eventually gained enough financial resources to extricate myself, but it sadly started with lying to the psychiatrist and my parents…. pretending to take the drugs while I titrated myself off them. I can’t legally tell others to do that (although I’d like to, because the idea that a guiding psychiatrist is necessary to titrate off drugs is a myth and often not practically possible). I would do whatever it took again if I had to.

          I am just so sick of seeing these lies in the media about psychosis being a genetic disease and people needing neuroleptics as the first line treatment. I hope that if people see people who recovered, who also happen to be people who have zero respect for the methods and ideas of disease-model psychiatrists, it will encourage them to think for themselves.

    • “Much work has been done in the past decade to understand the relationship to dopamine dysregulation; which McEvoy said, “underlies the onset of psychosis.”

      This is a confession that the psychiatric community doesn’t understand the first thing about how their dopamine dysregulating drugs affect people, other than forcing dopamine dysregulating drugs onto people is what “underlies the onset of psychosis.”

      Perhaps the medical community should stop prescribing / coercing / forcing people onto dopamine dysregulating drugs?

      And since we know it’s the dopamine dysregulating drugs that underlie “the onset of psychosis,” then we also know this is an iatrogenic, not genetic, problem.

  2. Another no-brainer research study. People do better with social support and worse when they don’t have it. Unfortunately, they missed the biggest point: the other “treatment” did nothing to maintain any gains they made from receiving social support! Drug “treatment” should, at most, be offered as an adjunct temporary aide toward the goal of social reintegration, which is the real solution. The WHO studies and the Open Dialog and Soteria experiments should have convinced anyone paying attention of this, but I guess there are a lot of people in the industry who make money off of not paying attention to the actual research.

    —- Steve

  3. I think it’s unfair to generalize. Personally, I prefer a small close knit social group (five or six close friends) and steer clear from larger groups, especially groups that identify themselves as “ill”. In my experience, going it alone is preferably and has fewer side effects than faking it in a “group” of people who cannot accept my weaknesses and strengths. As someone who recovers from years of trauma, trust is an issue. Being around others can be exhausting to someone who is always on guard. Social supports are important but also is allowing someone to define for themselves what that looks like.
    All the rest was the typical BS that psychiatry pathology pushes. It’s getting old.

      • There are also plenty of free support groups in pretty much any urban or suburban area for trauma survivors, including domestic abuse victims, sexual assault victims, victims of childhood sexual abuse, adult children of alcoholics, and many others. There are also groups like “women in transition” that offer support for changes in life circumstances, such as returning to work after childrearing.

        — Steve

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