Study Highlights Importance of Social Interactions in Psychosis Recovery

Frequency of social interactions predicts long-term remission in first episode psychosis

Bernalyn Ruiz

A study published in Frontiers in Psychology explores the social predictors of symptomatic remission after a first episode of psychosis (FEP). Researchers found that frequency of social interactions with friends, but not satisfaction or frequency of interaction with family members, significantly predicted positive long-term outcomes.

“[The] study findings imply that professionals perhaps should deemphasize the subjective assessments of relational qualities in the early customization of treatment and evaluation of treatment efficacy in the initial phase of the course.”

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Researchers were interested in better understanding the impact of friendship and family networks on long-term remission for people who have experienced a first episode of psychosis. Previous research has demonstrated that diminished social functioning (assessed by social networks, friendships, social relationships, etc.) is associated with the onset of psychosis, hospitalization, and unfavorable treatment outcomes.

Alternatively, active social networks (particularly with friends) have been linked to numerous favorable outcomes including less perceived stigma, lower reports of loneliness, better self-care functioning, and symptom reduction. The authors of this study aimed to improve on prior studies by looking only at FEP and by better parsing out the social functioning construct. Previous studies included many variables such as family relations, the frequency of interactions, and satisfaction into one global ‘social functioning’ category. Alternatively, this study looked at friendships relative to family relationships and the effects of relational frequency relative to relational satisfaction.

The study sample included 186 persons identified as FEP recruited from the Treatment and Intervention in Psychosis (TIPS-2) study in Norway. Participants were assessed at three months, 1, 2, and 5 years. Social predictors were measured with subscales from the Lehman’s Quality of Life Interview (LQoLI). These included: 1) satisfaction with family relations, 2) social relations, 3) daily activities, 4) frequency of family contact, 5) frequency of social contacts.

The ‘objective’ functioning was determined by the frequency (4 and 5) subscales, and ‘subjective’ functioning was measured by satisfaction with social relations (1, 2, and 3) subscales. The outcome of interest was remission, measured as no score higher than four on the Positive and Negative Symptom Scale (PANSS). Individuals were considered as non-remitted if they reported any relapse, or a score greater than three on relevant PANSS scales in the last six months.

The study results indicate that frequency of social interaction with friends is a significant positive predictor of remission after 2-years. Seventy-seven of the 225 (34.2%) individuals met remission criteria at one-year follow-up, and 79 of 167  (47.3%) were remitted at 2-year follow-up. Those who remitted had higher scores on friends and family satisfaction, the frequency of interaction with friends, and the frequency of interaction with friends and relatives.

Interestingly, while the social satisfaction score alone did not predict better outcomes, the frequency of social interactions did significantly predict remission. When comparing the frequency of communication with family and the frequency of interaction with friends, only the frequency of interaction with friends significantly predicted remission.

The authors suggest that this study provides support for increasing early social frequency through supported socialization as previous studies have demonstrated the positive impact of such an approach for achieving positive long-term outcomes.



Bjornestad, J., Joa, I., Larsen, T. K., Langeveld, J., Davidson, L., ten Velden Hegelstad, W., … & Bronnick, K. (2016). “Everyone Needs a Friend Sometimes”–Social Predictors of Long-Term Remission In First Episode Psychosis. Frontiers in psychology, 7. (Full Text)