Social Functioning and Support in First-Episode Psychosis

First-episode psychosis (FEP) commonly arises in late adolescence or early adulthood and profoundly disrupts social development. Individuals often experience withdrawal from family, friends and educational or occupational activities, leading to isolation and diminished quality of life. Social functioning—the capacity to establish and sustain relationships, participate in community roles and fulfil age-appropriate tasks—is a core determinant of long-term recovery. Early intervention services strive to address this by combining medication, individual and group therapies, family involvement and vocational support. More recently, digital innovations and peer-moderated networks have been introduced to supplement in-person care, offering flexible access to psychoeducation, peer encouragement and guided social interaction. Evidence highlights heterogeneity in response: some patients regain social engagement rapidly, while others remain socially disconnected despite comprehensive intervention. Factors influencing outcomes include severity of negative symptoms, cognitive impairments, stigma and the strength of informal support networks. Internationally, enhancing social support has been recognised as both a clinical imperative and a public health priority, with implications for service design, training of specialist teams and policy frameworks that promote early detection, co-production with service users and the integration of novel digital tools.

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Social Functioning and Support in First-Episode Psychosis publication trend

The graph below shows the total number of articles in social functioning and support in first-episode psychosis across all publications each year (not limited to Nature Index journals).

Technical terms

First-episode psychosis: The initial onset of psychotic symptoms, typically including hallucinations or delusions, occurring in individuals with no prior exposure to antipsychotic treatment.

Social functioning: The ability to perform roles and activities across family, friendship, educational and occupational domains, reflecting real-world integration.

Social support: The network of family, friends, peers and professionals offering emotional, informational or practical assistance to individuals.

Online social networking intervention: A purpose-designed digital platform facilitating moderated peer-to-peer interaction alongside therapeutic content and professional oversight.

Social recovery therapy: A structured psychosocial approach that combines personalised goal-setting, behavioural activation and community integration strategies to improve social functioning.

Structured activity: Scheduled tasks encompassing work, study, volunteering or organised leisure, used as an objective measure of functional engagement.

References

1. Understanding What Drives Long-term Engagement in Digital Mental Health Interventions: Secondary Causal Analysis of the Relationship Between Social Networking and Therapy Engagement. JMIR Mental Health (2023).
2. Digital health innovation to prevent relapse and support recovery in young people with first-episode psychosis: A pilot study of Horyzons-Canada. Schizophrenia (2023).
3. Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial. The Lancet Psychiatry (2017).