The Role of Social Networks in the Maintenance of Schizophrenic Patients

Abstract

SUMMARY The levels of social support available to the nearest relatives of a sample of 45 outpatient schizophrenics are measured in terms of both the structure of their social networks and the quality of their network relationships. It is hypothesized that the level of social support available to the closest associate of the schizophrenic patient is linked to the level of functioning found in the patient. Good social performance in the patient is found with the structural aspects of the nearest relative's social network whereas good clinical performance in the patient is related to the interactional aspects of the relative's network. The results indicate that a view of maintenance in schizophrenic patients which incorporates both social and clinical functioning needs to consider the structural as well as the interpersonal characteristics of the networks of their closest associates. In recent years increasing attention has been paid to the influence that family members might have on the course of schizophrenia. Initial findings on the role played by the living group to which the long stay schizophrenic patient was discharged revealed that those patients who adjusted most successfully were those who returned to live alone, in lodgings or to distant relatives. Those most likely to relapse and require hospital readmission were those who returned to the close emotional ties of a spouse or parents (Brown, 1959). More careful examination of the families to which schizophrenic patients were discharged focussed on the different levels of expressed emotion (EE) which relatives revealed when talking about the patient and it was shown that relatives conveying high levels of expressed emotion (as measured by emotional overinvolvement, hostility and critical comments when talking about the patient) were much more likely to have a patient relapsing in the nine months following his discharge than relatives whose level of expressed emotion was low (Brown et al. 1972; Vaughn and Leff, 1976). Additionally, spending less than 35 hours per week in face to face contact with the relative and taking medication were found to reduce