Social connectedness might positively influence the course of clinical symptoms in people with psychotic disorders.

This study examines satisfaction with social connectedness (SSC) as predictor of positive and negative symptoms in people with a psychotic disorder.

Data from the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS, 2014-2019) was used from patients diagnosed with a psychotic disorder (N=2109). Items about social connectedness of the Manchester short assessment of Quality of Life (ManSA) were used to measure SSC. Linear mixed models were used to estimate the association of SSC with the Positive and Negative Syndrome Scale (PANSS) after one and two years against α=0.01. Analyses were adjusted for symptoms, time since onset, gender and age. Additionally, fluctuation of positive and negative symptom scores over time was estimated.

Mean duration of illness of the sample was 18.8 years (SD 10.7) with >65% showing only small variation in positive and negative symptoms over a two to five-year time period. After adjustment for covariates, SSC showed to be negatively associated with positive symptoms after one year (β=-0.47, p<0.001, 95% CI=-0.70,-0.25) and two years (β =-0.59, p<0.001, 95% CI = -0.88,-0.30), and for negative symptoms after one year (β=-0.52, p<0.001, 95% CI = -0.77,-0.27). The prediction of negative symptoms was not significant at two years.

This research indicates that interventions on SSC might positively impact mental health for people with psychosis. SSC is a small and robust predictor of future levels of positive symptoms. Negative symptoms could be predicted by SSC at one year.

No significant relationships.

Negative symptoms in patients with schizophrenia are strongly associated to disease burden. Aerobic exercise might be beneficial in treating negative symptoms.

The meta-analysis aims to evaluate the effect of aerobic exercise on negative symptoms in schizophrenia.

The Cochrane Library, Medline, Embase, PsycINFO and CINAHL were searched from their inception until 16 March 2014. Randomised controlled trials (RCT's) comparing aerobic exercise with other psychosocial interventions in schizophrenia were included if negative symptoms were assessed. The methodological quality of the studies was assessed with the Clinical Trial Assessment Measure (CTAM).

Nine studies were included (N= 488). Seven out of nine studies had poor methodological quality as measured with the CTAM. The meta-analysis showed a small non-significant treatment effect in favour of exercise interventions (Hedges’ g = -0.310, CI -0.787 0.168) with a power of 75%. The analysis indicates high heterogeneity (Q(8)=37.163 (P<0.000) I2= 75%). A meta-regression analysis showed that more training sessions were associated with a higher decrease in negative symptoms (Hedges’ g = 0.460 -0.006 0.925 (P=0.053)). This was confirmed in a moderator analysis including studies with >20 sessions (Hedges’ g = 0.640, CI -1.281 0.000, Q(5)=24.214 (P < 0.000) I2=79%).

A large significant effect of exercise was found in five studies comparing exercise to TAU (Hedges’ g=-1.370, CI -2.352 -0.389, Q(4)=29.278 (P< 0.000) I2=86%).

This meta-analysis demonstrated a significant effect of aerobic exercise on negative symptoms in schizophrenia compared to TAU, but no effect compared to any other (active) control condition. The quality of the included studies was low.