Nutzung und Einfluss von Online-Netzwerken und Internetforen bei Patienten mit der Diagnose Schizophrenie

During the past decade, the internet and particularly online networking platforms became very popular and seem to play an increasingly important role in our health care system. The present work is the first of its kind to examine how patients with the diagnosis schizophrenia use the internet. Emphasis is put on their exchange in online message boards and social networks to examine whether these can act as suitable complements to a conventional face-to-face therapy. The following methodology is used: In eight major hypotheses, along with five minor hypotheses the framework of this investigation is set up. These were translated into a comprehensive questionnaire to probe the statements. About 50 patients and 51 healthy persons of the age group 18–30 years responded to these questions and the insight gained from the analysis is used to verify/falsify the set of hypotheses and draw the conclusions outlined below. Patients suffering from schizophrenia use the Internet less frequently than the healthy and also spend less time using online message boards. Hence, they are not along the lines of increased (illness-related) online exchange as known from other psychiatric patients, e.g. those suffering from severe depression. While both, patients and healthy persons, use the internet for information acquisition the aforementioned make little use of online communication functionalities. It must be noted instead, that they show a strong affinity towards computers games, therefore the latter present an interesting approach for future therapy attempts. In contrast to social networks, participation in message boards was poor in both groups. The patients didn’t find them very helpful to redevelop an openness towards people they meet in real life. Both groups consider the acquired contacts via this route as rather insignificant. Patients experience real friendships as much more intense and prefer to talk directly about their problems rather than to third parties on the web. According to them, the indirect web-based communication has no particular advantages. In contrast to people with eating disorders, exchange in message boards has no direct consequences on the illness management of schizophrenia patients. Another main area of interest concerns how the deficits in communication skills (e.g. contextualization, recognition of emotions and theory-of-mind abilities) impose an additional interference for schizophrenia patients. A direct comparison to healthy person suggests deficits particularly in theory-of-mind abilities. The majority of the patients considers online therapy for not conceivable and would always prefer the direct conversation with therapists to cope with illness-relates problems. If they would be asked for an online therapy it has to be strictly anonymous. Despite its increasing importance for communication, schizophrenia patients do not consider the internet an asset with regard to an improved social integration, for example by using online communities to keep in touch with friends or to get to know people. In order to develop successful approaches towards an online therapy for these patients, future studies should be aware of their illness–related deficits in communication skills and employ appropriate efforts of inclusion.