Previously submitted to: JMIR Mental Health (no longer under consideration since Nov 20, 2025)
Date Submitted: Sep 22, 2025
Open Peer Review Period: Sep 22, 2025 - Nov 17, 2025
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Social Media Use and Perceived versus Objective Social Functioning in Schizophrenia: A Cross-Sectional Study
ABSTRACT
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.
Citation
The author of this paper has made a PDF available, but requires the user to login, or create an account.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.