The relationship between social media and schizophrenia and other psychotic disorders: a systematic review

Abstract Background and Hypothesis The impact of social media on individuals with schizophrenia and other psychotic disorders is poorly understood. We conducted a systematic review to summarize the existing literature on the association between social media use and symptoms in this population. Study Design A systematic search was conducted in PubMed, Embase and Medline, from January 2010 to May 2025. We included studies which reported an association between social media use and symptoms of schizophrenia and other psychotic disorders, except for reviews. Search results were screened using Rayyan, and data was extracted according to predefined categories. Study Results The included studies were largely cross-sectional (64%), and had moderate-high risk of bias. However, some key findings emerged. Firstly, social media was linked with fewer negative symptoms and better functioning. Secondly, there was no association between increase in positive symptoms and social media use. Thirdly, the impact of social media on broad psychological distress and symptoms was dependent on engagement type. Finally, qualitative insights confirmed that this population are aware of the risks surrounding social media use; however, they also acknowledged many benefits from its use, including social connection. Conclusions This review has clinical and public health implications, such as the need for digital literacy interventions promoting healthy social media use. However, implications are limited by the high risk of bias in findings. Future research should investigate this relationship further through randomised trials and use digital phenotyping to understand social media use patterns and their consequences based on type of engagement and platform.