The intensity and correlates of the feelings of loneliness in people with psychosis

Abstract

OBJECTIVE: Loneliness is an established risk factor for numerous negative health outcomes. The aims of the present study were to compare the levels of loneliness between patients with psychotic disorders and members of the general population and to identify factors independently associated with loneliness in psychosis. METHODS: A total of 207 patients with psychotic disorders recruited between February 2013 and February 2015 from inpatient and day wards and an outpatient clinic of the Institute of Psychiatry and Neurology (IPN) in Warsaw (Poland) were included in this cross-sectional study. They were administered the De Jong Gierveld Loneliness Scale (DJGLS) and a set of instruments assessing three types of explanatory variables: socio-demographic, psychosocial and psychiatric (clinical). The comparison group was a random sample of 20,000 inhabitants of Poland who took part in the Generations and Gender Survey (GGS-PL) conducted in 2011. The two groups were matched for socio-demographic characteristics. RESULTS: The patient sample proved to be significantly lonelier than the general population sample. The higher level of loneliness in people with psychotic disorders was most strongly related to psychosocial factors, particularly more severe internalized stigma and lesser social support, followed by worse interpersonal competence and smaller social network. After adjusting for socio-demographic and psychosocial variables, the only clinical variable significantly associated with more intense feelings of loneliness turned out to be the greater number of psychiatric inpatient admissions. The findings did not lend support to the view that socio-demographics play a major role in explaining variation in loneliness in psychosis. CONCLUSIONS: People with psychotic disorders are predisposed to experiencing elevated levels of loneliness. To counteract the pernicious effects of this on their health and well-being, there is a need for comprehensive therapeutic programs targeting self-stigma, enhancing social support networks and improving social skills.