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Vicary E, Kapadia D, Bee P, Bennion M, Brooks H. The impact of social support on university students living with mental illness: a systematic review and narrative synthesis. J Ment Health 2024:1-13. [PMID: 39375995 DOI: 10.1080/09638237.2024.2408237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/30/2024] [Accepted: 08/14/2024] [Indexed: 10/09/2024]
Abstract
BACKGROUND Limited reviews address the role of social support for university students with mental health issues, despite its proven significance for other vulnerable groups. AIMS The current review aims to examine the current evidence on the nature and impact of social support for students with self-reported and diagnosed mental health problems, along with the availability and effectiveness of social support interventions. METHODS Electronic databases (CENTRAL, CINAHL, Embase, HMIC, MEDLINE, PsycINFO, SCOPUS, Web of Science) and grey literature databases (EThOS, SSRN) were systematically searched from inception to March 2024 Articles were eligible for inclusion if they reported on the nature and role of social support for university students with mental health problems. Data from included articles were extracted and narratively synthesised. Quality of included studies was assessed using the Mixed Methods Appraisal Tool. RESULTS Ten studies, involving 3669 participants, were included. Findings indicated high social support significantly mitigated against suicide, depression, anxiety, and psychological distress. Barriers to support access and both positive and negative impacts on mental health were identified. CONCLUSIONS Results underscore the need to consider the distinct support requirements of students with mental health problems, who often face insufficient access to high social support. This emphasises the potential for effective interventions in this population.
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Affiliation(s)
- Emily Vicary
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Dharmi Kapadia
- Department of Sociology, University of Manchester, Manchester, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Mia Bennion
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Fitzgerald S, Chronister J, Zheng QM, Chou CC. The Meaning of Social Support for Mental Health Service-Users: The Case Managers' Perspective. Community Ment Health J 2024:10.1007/s10597-024-01349-5. [PMID: 39230859 DOI: 10.1007/s10597-024-01349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/18/2024] [Indexed: 09/05/2024]
Abstract
This study sought to understand the unique types of social support salient to mental health service-users from the perspective of case managers. The sample consisted of case managers working in county mental health agencies in the southwest and west coast. Data was gathered from three focus groups and analyzed using NVivo 10 and Consensual Qualitative Research. Six themes were described including relational support, consistency support, validation and affirmation support, social connection support, day-to-day living support and vocational support. While the social support domains described in this study share conceptual underpinnings with traditional conceptualizations of support, our findings reveal unique types of support from the perspective of case managers. Findings from this study offer an important perspective-case managers-to the extant body of research investigating the meaning of social support for people with lived mental health experiences. Of particular interest is the finding that relational support, affirmative and validation support, and consistency support are salient case manager functions.
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Affiliation(s)
- Sandra Fitzgerald
- Department of Counseling, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA, 94132, USA.
| | - Julie Chronister
- Department of Counseling, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA, 94132, USA
| | | | - Chih-Chin Chou
- Rehabilitation and Mental Health Counseling Program, University of South Florida, Tampa, USA
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Iliuta FP, Manea MC, Teodorescu A, Lacau RM, Manea M, Mares AM, Varlam CI, Ciobanu CA, Ciobanu AM. Predictive factors and symptom severity spectrum in adult schizophrenia: Potential insights for improved management and adequate care. Biomed Rep 2024; 21:132. [PMID: 39114301 PMCID: PMC11304515 DOI: 10.3892/br.2024.1820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 07/04/2024] [Indexed: 08/10/2024] Open
Abstract
Schizophrenia is one of the most disabling psychiatric disorders characterized by positive (hallucinations, delusions, formal thinking disorder) and negative symptoms (anhedonia, lack of speech and motivation). The present study aimed to identify the predictive factors of schizophrenia in adults, and potential differences in the environment of origin, sex, levels of occupational stress, intellectual level, marital status and age of onset of the disease depending on the severity of symptoms using analysis of data collected from 120 patients with a diagnosis of schizophrenia. The study was conducted at the 'Prof. Dr. Alexandru Obregia' Clinical Psychiatric Hospital in Bucharest and included adult patients hospitalized between March 2018 and January 2021 diagnosed with schizophrenia and evaluated by general clinical examination, psychiatric, neurological and psychological evaluation. Results revealed that robust predictors of mild and moderate symptoms were affective symptoms, heredo-collateral history of schizophrenia, late onset, the presence of positive and negative symptoms, substance abuse, stress and marital status, unmarried, lower IQ and mental deficiency. For moderate-severe and severe symptoms, predictors were affective symptoms, heredo-collateral history of schizophrenia and affective disorders, substance abuse, stress, borderline IQ and mild mental deficiency. The present results can be used for further development of psychopharmacological management of schizophrenia.
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Affiliation(s)
- Floris Petru Iliuta
- Department of Psychiatry and Psychology, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 010221, Romania
| | - Mihnea Costin Manea
- Department of Psychiatry and Psychology, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 010221, Romania
| | - Andreea Teodorescu
- Faculty of Medicine, Transilvania University of Brasov, Brasov 500019, Romania
| | - Radu-Mihail Lacau
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, Bucharest 041914, Romania
| | - Mirela Manea
- Department of Psychiatry and Psychology, Faculty of Dental Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 010221, Romania
| | - Aliss Madalina Mares
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, Bucharest 041914, Romania
| | - Corina Ioana Varlam
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, Bucharest 041914, Romania
| | | | - Adela Magdalena Ciobanu
- Department of Neurosciences, Discipline of Psychiatry, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest 050474, Romania
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Alvarez CV, Mirza L, Das-Munshi J, Oswald TK. Social connection interventions and depression in young adults: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02722-1. [PMID: 39150513 DOI: 10.1007/s00127-024-02722-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 06/24/2024] [Indexed: 08/17/2024]
Abstract
PURPOSE Early adulthood is a period which may increase vulnerability to loneliness and mental health difficulties among young adults. Social networks play an important role in buffering against adverse mental health, but there is a lack of evidence around whether social connection interventions could play a role in preventing mental health difficulties for young adults. METHODS A systematic review and meta-analysis was conducted (PROSPERO ID: CRD42023395595). PubMed, PsycInfo, and Scopus were searched (01 January 2000-01 January 2023). Studies were eligible if they (i) were quantitative, (ii) included young adults (18-24 years) from the general population, (iii) tested a social intervention which aimed to increase the quantity or quality of social connections or reduce loneliness, (iv) had a comparison group, and (v) measured depression and loneliness/social connection as outcomes. Following study screening and selection, the data extraction and risk of bias assessments were independently conducted in duplicate. The Cochrane RoB-2 tool and ROBINS-I tool were used to assess risk of bias. Results were narratively synthesised and random effects meta-analysis with standardised mean differences was conducted. RESULTS Six studies were included; four in-person interventions with higher education students, one online intervention with higher education students, and one intervention for youth involved in street life. The studies were mostly rated as having some or moderate concerns with risk of bias. The interventions were associated with an overall mean reduction in depression for young adults (SMD = -0.19; 95% CI, -0.33 to -0.05; p = 0.008; 4 studies, excluding studies with serious risk of bias). All interventions had beneficial effects on a range of diverse social connection outcomes, but there was no overall statistically significant mean reduction in loneliness for young adults in pooled analyses (SMD = -0.10; 95% CI, -0.24 to 0.05; p = 0.188; 3 studies). CONCLUSION Social connection interventions show some promise in improving depression and social connection outcomes in young adults but more high-quality research, across diverse settings, is needed in this area.
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Affiliation(s)
- Clotilde Vazquez Alvarez
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Luwaiza Mirza
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- University Hospitals Sussex, Sussex, UK
| | - Jayati Das-Munshi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
- South London & Maudsley NHS Trust, London, UK
- Population Health Improvement UK (PHI-UK), London, UK
| | - Tassia Kate Oswald
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Population Health Improvement UK (PHI-UK), London, UK.
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Vázquez Morejón AJ, León Rubio JM, Vázquez-Morejón R. Sources of social support and clinical and functional evolution of people with schizophrenia. Int J Soc Psychiatry 2023; 69:1377-1387. [PMID: 37081764 DOI: 10.1177/00207640231164284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
PURPOSE The impact of social support on comprehensive measures of results (clinical and functional) of the course of schizophrenia was studied, understood and evaluated as a multidimensional construct differentiating sources of support (family vs. nonfamily). METHODS One hundred fifty-two patients diagnosed with schizophrenia were assessed with the Mannheim Interview on Social Support (MISS) and the Social Functioning Scale (SFS). The hypotheses were explored in a prospective longitudinal design, using a causal correlational analysis for their evaluation by applying structural equation models. RESULTS The only explanatory factor of social functioning was Nonfamily social support, while the only explanatory factor of clinical result measurements was Family social support, observing a clearly differentiated impact of the different sources of support on the schizophrenia result measurements. It was also found that while Family social support explained 6.8% of the variance in the clinical result measurements, Nonfamily social support explained 13.7% of the variance in social functioning. CONCLUSION The results confirmed the differential importance of social support variables (family vs. nonfamily) in the clinical and functional result measurements of people with schizophrenia.
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Swinkels LTA, van der Pol TM, Twisk J, ter Harmsel JF, Dekker JJM, Popma A. The effectiveness of an additive informal social network intervention for forensic psychiatric outpatients: results of a randomized controlled trial. Front Psychiatry 2023; 14:1129492. [PMID: 37293397 PMCID: PMC10244564 DOI: 10.3389/fpsyt.2023.1129492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/02/2023] [Indexed: 06/10/2023] Open
Abstract
Objectives A supportive social network is associated with better mental health and wellbeing, and less criminal behavior. Therefore, this study examined the effectiveness of an additive informal social network intervention to treatment as usual (TAU) among forensic psychiatric outpatients. Materials and methods An randomized controlled trial (RCT) was conducted in forensic psychiatric care, allocating eligible outpatients (N = 102) to TAU with an additive informal social network intervention or TAU alone. Participants receiving the additive intervention were matched to a trained community volunteer over 12 months. TAU consisted of forensic care (e.g., cognitive behavioral therapy and/or forensic flexible assertive community treatment). Follow-up assessments were conducted at 3, 6, 9, 12, and 18 months after baseline. The primary outcome was the between-group effect on mental wellbeing at 12 months. Between-group effects on secondary outcomes (e.g., general psychiatric functioning, hospitalization, criminal behavior) were explored. Results Intention-to-treat analyses showed non-significant between-group effects on mental wellbeing on average over time and at 12 months. However, significant between-group effects were found on hospitalization duration and criminal behavior. Specifically, TAU participants were hospitalized 2.1 times more days within 12 months and 4.1 more days within 18 months than participants in the additive intervention. Furthermore, TAU participants reported 2.9 times more criminal behaviors on average over time. There were no significant effects on other outcomes. Exploratory analyses revealed that sex, comorbidity, and substance use disorders moderated effects. Conclusion This is the first RCT examining the effectiveness of an additive informal social network intervention in forensic psychiatric outpatients. Although no improvements were found on mental wellbeing, the additive intervention was effective in reducing hospitalization and criminal behavior. The findings suggest that forensic outpatient treatment can be optimized by collaborating with informal care initiatives aimed at improving social networks within the community. Future research is warranted to determine which specific patients might benefit from the intervention and if effects can be improved by extending the intervention duration and enhancing patient compliance.Clinical Trial Registration: [https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7163], identifier [NTR7163].
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Affiliation(s)
- Lise T. A. Swinkels
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Amsterdam, Netherlands
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands
| | - Thimo M. van der Pol
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Amsterdam, Netherlands
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands
- Department of Research and Quality of Care, Arkin Mental Health Institute, Amsterdam, Netherlands
| | - Jos Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands
| | - Janna F. ter Harmsel
- Department of Forensic Outpatient Care, Inforsa Forensic Mental Healthcare, Amsterdam, Netherlands
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands
| | - Jack J. M. Dekker
- Department of Research and Quality of Care, Arkin Mental Health Institute, Amsterdam, Netherlands
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, Netherlands
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Cohen CI. Social Networks and Residential Status in Community-Dwelling Older Adults With Schizophrenia: Compensation by Reconfiguration? Am J Geriatr Psychiatry 2022; 30:1159-1167. [PMID: 35654726 DOI: 10.1016/j.jagp.2022.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To address the paucity of data on the structure and content of social networks of older adults with schizophrenia (OAS). METHODS The OAS group comprised 249 persons aged 55 and older with early-onset schizophrenia living in supportive housing (SS; n = 151), independently (SI; n = 70), or with family (SF; n = 28). The community comparison (CC) group comprised 113 individuals. Social network analysis was used. Multinomial logistic regression with p ≤0.001 and p ≤0.05 was used for overall and pairwise comparisons, respectively. RESULTS Each OAS subgroup had more total, nonkin, and formal linkages than the CC group. The SS and SI subgroups had fewer kin linkages than the CC group. The CC group had more confidants than the SS subgroup, more reliable linkages than the SS and SI subgroups, and more sustenance linkages than each of the OAS subgroups. Nearly everyone in the CC, SI, and SF subgroups had a confidant, a reliable contact, and a sustenance linkage; 33% of the SS subgroup had no confidants. The SS subgroup displayed more psychiatric symptoms than the SI and SF subgroups. There were no differences in loneliness or relationship satisfaction between the CC and the schizophrenia subgroups. CONCLUSION Networks were expressed differentially across residential arrangements and differences may reflect dissimilarities in psychiatric functioning. OAS generally had ample levels of companionship and emotional and instrumental support, often comparable to their age peers. Whereas social networks typically decline at illness onset and may be predominantly family-focused, later life may be a time of network reconfiguration and reconstitution.
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Affiliation(s)
- Carl I Cohen
- Division of Geriatric Psychiatry, SUNY Downstate Health Sciences University, Brooklyn, NY.
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