Maintaining Social Functioning After a Diagnosis of Schizophrenia

Psychosocial functioning is one of the most significantly impaired domains in individuals with schizophrenia. Unfortunately, this important aspect of life, which impacts relationships and interpersonal interaction, is also the most critical to the well-being of the individual. People with schizophrenia can benefit greatly from family support and personal relationships. However, without proper care, these relationships can deteriorate and become damaged in the very early stages of the illness. Determining which individuals are most at risk for schizophrenia is difficult at best and presents challenges for early intervention. Therefore, clinicians must work hard to determine how to identify and address unmet medical, physical, and social needs.

Social functioning declines most rapidly in the first several years immediately following the development of schizophrenia. Current diagnostic tools used for needs assessment are helpful at isolating which needs are met and unmet prior to treatment but do not provide direction for which approaches would benefit each individual the most. Therefore, Karin Landolt of the University of Zurich’s Department of General and Social Psychiatry in Switzerland recently conducted a study designed to determine the various classes of schizophrenic needs and how addressing these early on would impact psychosocial functioning.

Landolt evaluated individuals from the European First Episode Schizophrenia Trail (EUFEST) at baseline and again 6 and 12 months posttreatment. She found four specific classifications among the participants, representing four different trajectories of unmet needs from baseline to 12 months. The four classes included “autonomous” and “ordinary” classes, which had the fewest unmet needs at baseline. These groups had the lowest levels of baseline depression, highest levels of psychotherapy, and almost no unmet needs at 6 months. The other two classes, “uncomplicated” and “complicated,” had higher levels of baseline depression and more unmet needs at baseline. Although many needs eventually were met in the uncomplicated group, the complicated group maintained a high level of unmet needs at 6 and 12 months. Landolt said, “It became clear that the first 6 months were of outmost importance to treatment because the largest proportion of change in needs occurred during that period.” However, she added that the most significant gains were seen in those with fewer unmet needs at baseline and those that received therapy in addition to antipsychotic medication.

Landolt, K., Rossler, W., Burns, T., Ajdacic-Gross, V., Galderisi, S. (2012). Unmet needs in patients with first-episode schizophrenia: A longitudinal perspective. Psychological Medicine, 42.7, 1461-1473.

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  • Brian


    June 6th, 2012 at 4:11 AM

    Isn’t it sad that when we most often need other people, those are the times in our lives when we sometimes run away from them? Why is that? I guess in the case of a schizophrenic, people are afriad of what they don’t know and when they don’t know how to act they think that it’s best to go away, that there will be other people around to take care of them. But that’s not what happens. Typically everyone is going to run away from that which they don’t know, so that leaves someone with a mental illness alone and afraid at the time when they most likely need others the most.

  • jake


    June 6th, 2012 at 11:17 AM

    Just because you might not know how to react to something doesn’t give you the right to run away from it when the going gets a little tough.

    Would you like it if your friends and family members did this to you? Didn’t think so.

  • Carla


    June 7th, 2012 at 4:37 AM

    Probably one of the most difficult things about this first six months which is obviously such a critical point of time for patients who are rapidly developing scizophrenia, is that most families may not have recognized until now that there was a serious problem so they are spending this time trying to get help for the patient. In that time that they are scrambling like mad to get help, they could be losing such valuable communication time with that patient that may not ever be regained. All the more reason to promote early detection so that when the real descent begins you already have a plan in place for how to handle it.

  • Tracey


    June 7th, 2012 at 9:49 PM

    The hardest thing as the younger sibling was to get the family to admit my brother could even be helped. When the patient self medicates …CARE!
    Denial runs rampant in a home w/a schitzophrenic! Esp the first 5 yrs..

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