Support-receiving networks and the isolation in schizophrenia: A preliminary study toward recovery-oriented occupational therapy

Introduction: Social isolation is a major barrier to recovery for individuals with schizophrenia. Although prior studies examined social networks in relation to symptom severity and quality of life, few have integrated structural and relational dimensions of connectedness within a framework relevant to occupational therapy. This study investigated factors associated with social networks among individuals with schizophrenia in Japan, using Wang et al.’s conceptual framework and social network analysis. Method: A cross-sectional study was conducted with 31 individuals attending a psychiatric day-service center. Social isolation was assessed across four domains: network quantity, network quality, emotional appraisal (mattering and loneliness), and resource appraisal (helping and being helped). Multiple regression analysis identified factors related to network size, with significance set at p < 0.05. Results: Participants had extremely small networks, averaging fewer than one close contact. Regression analysis showed that only being helped by others was significantly associated with larger network size (β = 0.84, p < 0.0005). Loneliness, helping others, and mattering were not significant predictors. Conclusion: Individuals with schizophrenia may experience profound social isolation, with networks limited to relationships where they are recipients of help. Occupational therapy should promote opportunities for reciprocal, empowering connections to support recovery and community integration.