Understanding the Influence of Social Media and Loneliness on Mental Health Outcomes Among People with Psychosis

Jiménez, Emma (2026) Understanding the Influence of Social Media and Loneliness on Mental Health Outcomes Among People with Psychosis. Doctoral thesis, University of East Anglia.

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Abstract

Background:
Social connection and participation are central to recovery in psychosis, yet key social constructs remain under-researched and inconsistently assessed. This thesis examined loneliness as a subjective experience of isolation and social media use as a contemporary social behaviour. It aimed to clarify how these constructs relate to socio-occupational functioning (SOF) and clinically meaningful outcomes in psychosis.

Methods:
A systematic review narratively synthesised evidence on loneliness and SOF in psychosis. An empirical study was conducted using de-identified electronic health records to examine associations between social media use and service use and clinical outcomes among patients accessing early intervention in psychosis (EIP) services.

Results:
Twelve studies met inclusion criteria for the systematic review. Findings demonstrated an association between higher loneliness and poorer SOF, particularly in social participation, community integration and everyday functioning. However, associations varied by measurement approach and covariates included. Qualitative evidence suggested a bidirectional relationship between loneliness and SOF. In the empirical study (N=562), information about social media use was recorded for fewer than half of patients. Patients recorded as using social media were younger than nonusers, with no differences observed in other sociodemographic characteristics. Recorded social media use was associated with higher odds of suicidal ideation, but not with admissions, compulsory detention, length of stay, or symptom severity and functioning. Social media engagement style provided additional information: compared with passive use, active use was associated with increased admissions and higher odds of compulsory detention.

Conclusions:
The findings support the clinical relevance of social experience and behaviours in psychosis, while highlighting limitations in measurement and recording. Addressing subjective experiences (loneliness) and contemporary behaviours (including social media use) in routine care may inform risk and recovery. Further longitudinal, mixed-method and co-produced research is required to clarify mechanisms.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Amy Millward-Doherty
Date Deposited:	13 Nov 2026 15:47
Last Modified:	13 Nov 2026 15:47
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105117
DOI:

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