Declining social support in adolescents prior to first episode psychosis: Associations with negative and affective symptoms

Social support for individuals with psychosis is associated with decreased symptom severity, improved outcomes, and recovery. In adolescents, declining social support prior to the first hospitalization has been shown to predict time to relapse, which may have implications for early intervention. Data were collected on adolescents (n=84) following a first hospitalization for a psychotic episode in order to examine how change in social support relates to the duration and type of untreated symptoms. Most adolescents experienced a decline in social support (n=46) prior to index hospitalization. Chi-square analyses showed that declining social support was related to negative symptoms and longer duration of untreated psychosis, whereas stable social support was associated with manic symptoms and diagnosis of Bipolar disorder. When entered together into a logistic regression model, the decline in social support was primarily explained by the type of symptoms, rather than by the duration of untreated symptoms. These findings are relevant for targeting psychosocial treatments toward adolescents who may have particular deficits in social support during the prodromal phase and first episode of psychosis.