Social Life in the Schizophrenia Spectrum: A Phenomenological Study of Five Patients.

BACKGROUND

Social difficulties are a hallmark of schizophrenia spectrum conditions, yet their background and exact nature remain contested. Previous pivotal studies on chronically ill patients have suggested that a position of "positive withdrawal" is associated with a decreased tendency to rehospitalization. This concept designates an essentially withdrawn but not negatively experienced position balanced by elements relating the individual to the social world.

OBJECTIVES

To explore a less ill subgroup of schizophrenia spectrum patients' ways of navigating the social world and examine potential links to anomalous self-experiences by applying key insights from phenomenology and anthropology.

METHOD

The present study was part of a 5-year follow-up on a group of first-admission schizophrenia spectrum patients. From this sample of 48 patients, 5 were selected for qualitative evaluation following the principles of thematic analysis.

RESULTS

A "positively withdrawn" position characterizes a wider group of patients than originally reported. Further, we identified a preference for partaking in social activities in particular circumstances with clearly circumscribed goals or social roles and rules. This alleviated social discomfort and helped patients stay embedded in a social milieu. All patients experienced high levels of self-disorders.

CONCLUSIONS

We suggest that certain aspects of social impairment may, in fact, reflect meaningful compensatory mechanisms, and argue that this conceptualization of social difficulties is relevant to various psychotherapeutic interventions.