Psychological and neuropsychological predictors of time use and social recovery in early psychosis

This paper first provides a brief review of the evidence on clinical, psychological and neuropsychological predictors of social outcome in early psychosis. We next briefly describe a new assessment tool to assess time use in early psychosis which can provide a sensitive measure of social recovery. The main aim will be to report data on the association of time use and involvement in social activity (employment and education) with clinical, psychological and neuropsychological factors from two new studies. The first is prospective study of over 100 consecutive referrals to a uk early intervention service, the second is a study of over 70 cases who have entered an MRC funded randomised controlled trial of social recovery in early psychosis: the Improving Social Recovery in Early Psychosis (ISREP) trial. These studies highlight that levels of non-psychotic but distressing symptoms (in particular schizotypal symptoms, paranoia and social anxiety), and appraisals of negative beliefs about self and others, hopelessness and stigmatisation as well as neuropsychological factors may be associated with lack of social recovery. Succesful interventions to address social recovery in early psychosis need to be based on psychological understanding of ongoing symptoms and the need for withdrawal, and also take account of the emotional impact and meaning of social recovery to the person, the person can then be effectively prepared to make best use of any social opportunities which can be provided. A cognitive behavioural formulation is presented.