Loneliness in Psychosis: A Meta-analytical Review

Rocha, Beata Michalska da; Rhodes, Stephen; Vasilopoulou, Eleni; Hutton, Paul

doi:10.1093/schbul/sbx036

Cited by 202 publications

(169 citation statements)

References 54 publications

(28 reference statements)

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“…More severe affective symptoms (a summary score including symptoms of anxiety, depression, suicidality, and guilt) were associated with greater loneliness, while severity of positive symptoms or that of negative symptoms of psychosis had no association with loneliness. A recent systematic review found contradictory results about the relationship between loneliness and psychotic symptomatology [45], but findings from a meta-analysis reported a moderate association between loneliness and psychosis [46]. The relationship between depressive symptoms and loneliness was stronger and more consistent in the previous studies.…”

Section: Discussionmentioning

confidence: 75%

Epidemiology of loneliness in a cohort of UK mental health community crisis service users

Wang

Lloyd‐Evans

Marston

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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Purpose Loneliness is an important issue for mental health service users. However, it has not been a particularly prominent focus of recent mental health research. This paper aimed to explore the severity of loneliness among people leaving mental health community crisis services, and to identify factors associated with loneliness. Methods A total of 399 participants experiencing mental health crises recruited for a research trial from community crisis services were included in this cross-sectional study. They completed the eight-item measure of the University of California at Los Angeles Loneliness Scale and a set of instruments assessing socio-demographic, psychosocial, and psychiatric variables. Results Severity of loneliness was high among people leaving community crisis services. Longer years since first contact with mental health services (2-10 years, coefficient = 1.83, 95% CI 0.49-3.16; more than 10 years, coefficient = 1.91, 95% CI 0.46-3.36) and more severe affective symptoms (coefficient = 0.32, 95% CI 0.23-0.40) were associated with greater loneliness, whereas bigger social network size (coefficient = − 0.56, 95% CI − 0.76 to − 0.36) and greater social capital (coefficient = − 0.16, 95% CI − 0.31 to − 0.003) were associated with less severe loneliness. Conclusions This paper supports a view that people experiencing mental health crises often report relatively severe loneliness, and that loneliness tends to become more severe during the course of illness. A greater awareness of loneliness among mental health professionals may be beneficial. Loneliness is a potential focus of the development of interventions to improve the lives and outcomes of people with significant mental health problems.

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Section: Discussionmentioning

confidence: 75%

Epidemiology of loneliness in a cohort of UK mental health community crisis service users

Wang

Lloyd‐Evans

Marston

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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“…En l'absence de connaissances sur les effets du confinement sur les hallucinations, il faut être prudent sur nos conclusions. Les données disponibles restent contrastées, et le lien causal entre isolement social et psychose demande encore à être confirmé (46). Le suivi rapproché des patients suivis pour schizophrénie laisse espérer que les conséquences de ce confinement pour ces patients seront modérées.…”

Section: J O U R N a L P R E -P R O O Funclassified

Conséquences psychopathologiques du confinement

Mengin

Allé

Rolling³

et al. 2020

L'Encéphale

161

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Les effets psychologiques de l'isolement ont déjà été décrits dans la littérature (expéditions polaires, sous-marins, prison). Néanmoins l'échelle du confinement mis en oeuvre à l'occasion de la pandémie à COVID-19 est inédite. Il nous faut non seulement relire les études publiées, mais aussi anticiper les problèmes psychologiques qui pourraient survenir pendant ou à distance du confinement. Nous avons fait le choix d'aller au-delà de la littérature COVID-19 pour examiner les implications des conséquences connues du confinement : l'ennui, l'isolement social, le stress, le manque de sommeil. L'anxiété, le trouble de stress post-traumatique, la dépression et les conduites suicidaires, les conduites addictives, les violences domestiques sont des effets décrits du confinement, mais les mécanismes d'émergence de ces troubles et leurs interrelations restent à étudier. Par exemple, quels sont les mécanismes d'émergence du trouble de post-traumatique dans le cadre du confinement ? Nous rappelons aussi les points de vigilance à garder sur des conséquences telles que les troubles des conduites alimentaires, les hallucinations, curieusement ignorées dans la littérature sur le confinement, alors qu'une vaste littérature fait le lien entre isolement social et hallucinations. Du fait de conséquences psychopathologiques larges, il nous faut partir à la recherche des différents symptômes pour permettre leur prise en charge. Nous résumons rapidement les approches diagnostiques et thérapeutiques déjà mises en place, comme la télémédecine, qui connaît un développement rapide à l'occasion de la crise du COVID-19. AbstractThe psychological effects of isolation have already been described in the literature (polar expeditions, submarines, prison). Nevertheless, the scale of confinement implemented during the COVID-19 pandemic is unprecedented. In addition to reviewing the published studies, we need to anticipate the psychological problems that could arise during or at a distance from confinement. We have gone beyond the COVID-19 literature in order to examine the implications of the known consequences of confinement, like boredom, social isolation, stress, or sleep deprivation. Anxiety, post-traumatic stress disorder, depression, suicidal or addictive behaviours, domestic violence are described effects of confinement, but the mechanisms of emergence of these disorders and their interrelationships remain to be studied. For example, what are the mechanisms of emergence of post-traumatic stress disorders in the context of confinement? We also remind the reader of points of vigilance to be kept in mind with regard to eating disorders and hallucinations. Hallucinations are curiously ignored in the literature on confinement, whereas a vast literature links social isolation and hallucinations. As with domestic violence, we need to look for these symptoms in order to enable management. Due to the broad psychopathological consequences, we have to look for these various symptoms to manage them. We quickly summarize the diagnostic and therapeutic...

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“…Qualter et al, 2015;Cacioppo & Hawkley, 2009). Loneliness can be viewed as a transdiagnostic construct that occurs in range of mental health conditions/disorders, including psychosis (Michalska da Rocha, Rhodes, Vasilopoulou & Hutton, 2018) and suicidal behaviour (Stickley & Koyanagi, 2016). It has also been found to be related to symptoms of generalized anxiety and depression even when adjusting for the impact of other sources of distress (Beutel et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

A common elements approach to the development of a modular cognitive behavioral theory for chronic loneliness.

Käll¹,

Shafran²,

Lindegaard³

et al. 2020

Journal of Consulting and Clinical Psychology

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Background: Loneliness is a transdiagnostic clinical phenomenon that can significantly impact mental health and wellbeing across the lifespan.Objective: The aim was to combine existing theory and evidence-based treatment approaches to propose a comprehensive transdiagnostic cognitive behavioural analysis of the maintenance of chronic loneliness relevant across disorders, age groups and populations. Method:A distillation and matching model-framework approach was taken to identify interventions designed to reduce loneliness. Eligible studies were coded for the presence of practice elements. The findings were combined with an analysis of the broader literature on loneliness and psychopathology to derive a comprehensive cognitive behavioural analysis of the maintenance of loneliness over time across populations. Results: The search yielded 11 studies containing 14 practice elements with relative frequencies ranging from 7% to 64 %. The identified practice elements target putative mechanisms such as negative interpersonal appraisals, anxiety and social skills deficits. Counter-productive behaviour and cognitive processes such as self-focused attention were identified as maintenance factors based on the broader literature. A modular transdiagnostic model with multiple pathways is proposed to be consistent with the existing theoretical and treatment literature. Conclusions: Combining the distillation and matching model-framework with existing theory from the literature is a novel approach for developing a model of factors that maintain loneliness over time. The model has varying treatment implications for different populations including children with autism spectrum disorders and bereaved older adults. Targeting COMMON ELEMENTS APPROACH TO LONELINESS 3 transdiagnostic processes has the potential to transform interventions for loneliness across a range of formats and settings. What is the public health significance of this article?The systematic review and distillation procedure show that loneliness has been addressed with a wide range of techniques and strategies in efficacious interventions, with the most frequent ones targeting the participant's social skills. Additionally, the derived model generates potential ways of developing interventions for populations where loneliness is of concern.

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Loneliness in Psychosis: A Meta-analytical Review

Cited by 202 publications

References 54 publications

Epidemiology of loneliness in a cohort of UK mental health community crisis service users

Epidemiology of loneliness in a cohort of UK mental health community crisis service users

Conséquences psychopathologiques du confinement

A common elements approach to the development of a modular cognitive behavioral theory for chronic loneliness.

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