Schizophrenia: a network crisis.

The results of a study comparing the structure and function of the social networks of a group of first-admission schizophrenics with those of a group of multiple-admission schizophrenics are presented. Structurally, the networks of the first-admission patients are larger and more interconnected. Functionally, their networks have a greater percentage of multiplex and nondependent links. On the basis of these data, it is concluded that the most dramatic changes in social networks develop after the patient's first hospitalization. The dissolution of the patient's network is attributed to the antagonistic attitudes and reactions of those close to the patient, as well as to the patient's impaired social competence. Schizophrenia seemingly is a network crisis not only for the individual but for the network as a whole. It is suggested that active intervention at the time of the first psychotic episode may be helpful in avoiding network collapse and the patient's resultant social isolation.