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Social networks and service use among representative cases of psychosis in South London

  • Thomas Becker (a1), Graham Thornicroft (a1), Morven Leese (a1), Paul McCrone (a1), Sonia Johnson (a1), Maya Albert (a1) and David Turner (a1)...



Large social networks in patients with severe mental illness have been reported to be associated with a low rate of hospitalisation. We aim to determine whether social network size is related to the likelihood of hospitalisation and the amount of service use.


As part of a prospective controlled study, baseline interview data for a random sample of one-year prevalent cases with non-organic psychosis were analysed with respect to social network characteristics and service use during a six-month period.


The likelihood of hospitalisation decreased with an increase in network size, while the number of services used by patients grew as the social network size increased.


While larger social networks may be associated with a lower likelihood of hospitalisation, they may also be related to wider use of non-hospital services.


Corresponding author

Dr T. Becker. Section of Community Psychiatry (PRiSM). Institute of Psychiatry. De Crespigny Park. Denmark Hill. London SE5 8AF. Fax: 0171 277 1462


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Aberg-Wistedt, A., Cressell, T., Lidberg, Y., et al (1995) Two-year outcome of team-based intensive case management for patients with schizophrenia. Psychiatric Services, 46, 12631266.
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM–III–R). Washington. DC: APA.
Beecham, J. & Knapp, M. (1992) Costing psychiatric interventions. In Measuring Mental Health Needs (eds Thorni-croft, G., Brewin, C. & Wing, J.), pp. 163183. London: Gaskell.
Brugha, T. S. (ed.) (1995) Social Support and Psychiatric Disorder. Cambridge: Cambridge University Press.
Cole, E., Leavey, G., King, M., et al (1995) Pathways to care for patients with a first episode of psychosis. A comparison of ethnic groups. British Journal of Psychiatry, 167, 770776.
Davies, S., Thornicroft, G., Leese, M., et al (1996) Ethnic differences in risk of compulsory psychiatric admission among representative cases of psychosis in London. British Medical Journal, 312, 533537.
Dunn, M., O'Driscoll, C., Dayson, D., et al (1990) The TAPS project. 4: An observational study of the social life of long-stay patients. British Journal of Psychiatry, 157, 842848.
Faccincani, C., Mignolli, G. & Platt, S. (1990) Service utilisation, social support and psychiatric status in a cohort of patients with schizophrenic psychoses: a 7 year follow-up study. Schizophrenia Research, 3, 139146.
Fraser, M. W., Fraser, M. E. & Delewski, C. H. (1985) The community treatment of the chronically mentally ill: an exploratory social network analysis. Psychosocial Rehabilitation Journal. IX, 3541.
Gourash, N. (1978) Help-seeking: a review of the literature. American Journal of Community Psychology, 6, 413423.
Horwitz, A. (1977) Social networks and pathways to psychiatric treatment. Social Forces. 56, 86105.
Horwitz, A. (1978) Family, kin and friend networks in psychiatric help-seeking. Social Science and Medicine, 12, 297304.
Kent, S. & Yellowlees, P. (1995) The relationship between social factors and frequent use of psychiatric services. Australian and New Zealand Journal of Psychiatry, 29, 403408.
Lipton, F. R., Cohen, C. I., Fischer, E., et al (1981) Schizophrenia: a network crisis. Schizophrenia Bulletin, 7, 144151.
McGuffin, P., Farmer, A. & Harvey, I. (1991) A poly-diagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764770.
Mitchell, M. E. (1989) The relationship between social network variables and the utilization of mental health services. Journal of Community Psychology, 17, 258266.
Monroe, S. M., Bromet, E. J., Connell, M. M., et al (1986) Social support, life events and depressive symptoms: a 1-year prospective study. Journal of Consulting and Clinical Psychology, 54, 424431.
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799812.
StataCorp (1995) STATA Reference Manual Release 4, vols I & 2. College Station. TX: Stata Press.
Thornicroft, G. & Breakey, W. R. (1991) The COSTAR programme I: Improving social networks of the long-term mentally ill. British Journal of Psychiatry, 159, 245249.
World Health Organization (1992a) Schedules for Clinical Assessment in Neuropsychiatry (chief ed. Wing, J. K.). Geneva: WHO.
World Health Organization (1992b) The ICD–10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO.
Wykes, T. & Sturt, E. (1986) The measurement of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS schedule. British Journal of Psychiatry, 148, 111
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  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Social networks and service use among representative cases of psychosis in South London

  • Thomas Becker (a1), Graham Thornicroft (a1), Morven Leese (a1), Paul McCrone (a1), Sonia Johnson (a1), Maya Albert (a1) and David Turner (a1)...
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