Why Loneliness Matters in Clinical Practice: A Primer for Clinical- and Neuro-Psychologists.

Abstract

Aims: Loneliness has an adverse impact on mental health, yet it is often overlooked in psychological services. To inform clinical practice, we provide an overview of research hotspots on loneliness and mental health, the ‘state of the art’ in assessment and treatment, and workforce implications. Methods: Narrative synthesis. Results: Loneliness occurs in all age groups, with peaks in younger and older adults. It is a well-established risk factor for mental ill-health, neurodevelopmental and neurodegenerative disorders, and other problems prompting people to seek psychological care. A variety of psychometrically sound self-report measures are available for assessment purposes, though some lack structural or cross-cultural validity. The most promising interventions use cognitive-behavioural therapy to change maladaptive social cognitions. Recent studies are focused on identifying mechanisms of change, the role of social networks, and the use of digital technologies to augment treatment. The stigma of loneliness can prevent clients and healthcare professionals from talking openly about it, but the best strategies for combating loneliness stigma are unclear. Conclusion: Loneliness and mental ill-health are mutually reinforcing; hence, loneliness should be routinely considered in clinical practice. Psychological interventions are moderately effective at alleviating loneliness but further research and practice-based evaluation of solutions for loneliness is needed.

Urbanicity and Psychosis: Is there a Connection? A Comparative Study between an Urban and Rural Area in Portugal

“…17 The very assumption of psychosis being higher in migrant groups or ethnic minorities remains somewhat controversial; for example, UK studies point towards discrimination and social deprivation as causal factors, whereas USA studies take into account an elevated rate of misdiagnosis in the African American population. 18 In yet another study, higher psychosis risk was not associated with urbanicity per se: when factors such as ethnic minority status, owner occupancy of housing, household status (single person) and unemployment were accounted for, psychosis risk was not significantly associated with urbanicity. 5,19 Several studies show that within cities, first episode psychosis (FEP) incidence is higher in more deprived areas, with higher social fragmentation and lower social capital.…”