BACKGROUND Social isolation is a core challenge for individuals with schizophrenia. While the rise of social media offers new avenues for connection, its relationship with clinical symptoms and real-world social functioning in this population is complex and not fully understood. OBJECTIVE This study aimed to capture a baseline snapshot of social media adoption among patients with schizophrenia and to investigate how online engagement relates to both subjective self-perceived social adaptation and objective measures of functional recovery. METHODS We conducted a cross-sectional study with 55 clinically stable outpatients diagnosed with schizophrenia between December 2017 and April 2018. Participants completed a custom questionnaire on technology use and subjective experiences. Clinical and social functioning were assessed using the Scale for the Assessment of Positive and Negative Symptoms (SAPS/SANS), the Social Adaptation Self-evaluation Scale (SASS), and the Functional Remission of General Schizophrenia Scale (FROGS). RESULTS Daily social media use was reported by 27.3% (15/55) of participants. Social media users had significantly higher self-perceived social adaptation scores on the SASS compared to non-users (mean 34.9, SD 10.7 vs mean 27.7, SD 10.5; P=.017). Broader internet use was associated with significantly lower negative symptom scores on the SANS (P=.01) and higher functional remission scores on the FROGS (P=.001). However, there was no significant difference in FROGS scores between social media users and non-users (P=.159). Among the 21 social media users, 47.6% (10/21) reported that it helped them communicate with family and friends, while psychosis-specific risks were rare (4.8%, 1/21). CONCLUSIONS In this pre-pandemic cohort, social media use was associated with improved subjective social adaptation but not with objective functional recovery. The benefits appear linked to the maintenance of existing social ties (a form of active use), with minimal perceived clinical risk. These findings highlight a disconnect between online social confidence and real-world functioning, suggesting that future digital interventions should focus on bridging this gap.
Keleş et al. (Mon,) studied this question.