Loneliness in psychosis: A practical review and critique for clinicians.

Abstract

Accumulating evidence shows that loneliness in psychosis is a major concern for patients, is associated with poorer mental and physical health, and is a significant barrier to recovery. Although psychologists play a major role in treating the cognitive, emotional, and social difficulties of people with psychosis, loneliness is rarely addressed. This article presents a structured review and critique of the evidence base on loneliness in youth and adults with psychosis, framed around the knowledge, attitudes, and skills comprising clinical competencies as a foundation for clinical practice.

Deterioration of mental health despite successful control of the COVID-19 pandemic in South Korea.

“…Social isolation and loneliness have long been linked to poor mental and physical health outcomes (see Leigh-Hunt et al, 2017 for a review). Importantly, it has been shown that the subjective feelings of loneliness rather than objective measures of social contact or network contribute to psychosis-risk ( Badcock, Adery and Park, 2020 ; Michael and Park, 2016 ; Benson and Park, 2019 ). Indeed, the national lockdown enacted earlier this year to stem the spread of COVID-19 may have already resulted in increased psychosis risk in the general population in Italy (D'Agostino et al, 2020).…”

Alarming levels of psychiatric symptoms and the role of loneliness during the COVID-19 epidemic: A case study of Hong Kong

“…Although effective in flattening the epidemic curve ( Matrajt and Leung, 2020 ), these public health strategies severely disrupt daily social life and limit interpersonal interactions with adverse consequences of social disconnection and loneliness, which play a central role in poor physical and mental health outcomes ( Cacioppo et al., 2015 ). Loneliness has been linked to premature death from stroke and cardiovascular diseases ( Valtorta et al., 2016 ), altered expression of genes involved in inflammation and antiviral response ( Cole et al., 2015 ), as well as increased depression, generalized anxiety disorder, panic disorder, suicide risk and psychosis ( Badcock et al., 2020 ; Beutel et al., 2017 ). With the prolonged social distancing related to COVID-19, the general public will soon experience a surge in physical and mental illness.…”

Loneliness and its association with health service utilization in people with a psychotic disorder

“…For example, frequent use of hospital services by people with psychotic disorders could lead to increased selfstigma, social distancing and/or withdrawal, and self-stigmatizing attitudes to mental illness have been associated with heightened feelings of loneliness in people with psychosis (Chrostek et al, 2016). Feelings of loneliness may also indirectly worsen psychotic symptoms making increased use of health services necessary (for a review see Badcock et al, 2020;Michalska da Rocha et al, 2017). There is still much to be learned about loneliness in people with psychotic disorders (Lim et al, 2018).…”

“…However, the high prevalence of loneliness, detrimental impact on mental and physical health, social functioning and well-being (Badcock et al, 2019; Nevarez-Flores, 2020; Stain et al, 2012), and increased use of health services suggests that loneliness can no longer be "stigmatized, ignored, or trivialized" (Cacioppo and Cacioppo, 2018a;p. 426); rather, they indicate that new approaches to treatment and appropriate models of care are required (Badcock et al, 2020;Lim et al, 2019). For example, it has recently been proposed that psychosocial variables, such as loneliness and social isolation, should be routinely included as primary care quality indicators in electronic health records (Matthews et al, 2016).…”