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Correlates of loneliness among persons with psychotic disorders

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Abstract

Introduction

Persons diagnosed with schizophrenia spectrum disorders (SSDs) often experience pervasive feelings of loneliness, which are considered a significant barrier to treatment and recovery.

Aim

As impaired social cognition may contribute to increased loneliness and less skillful social interactions, this study examines the relationships between loneliness and measures of social cognition and functional outcome from the Social Cognition Psychometric Evaluation (SCOPE) study.

Methods

This study evaluated the relationship between loneliness, social cognitive ability, and social functioning in the context of a large-scale psychometric investigation. We also explored the associations of select demographic characteristics and clinical variables on the endorsement of loneliness in persons diagnosed with a psychotic disorder.

Results

Seventy-four stable outpatients with SSDs and 58 healthy controls completed the UCLA Loneliness Scale in addition to the standard SCOPE battery. Our findings support prior research indicating persons diagnosed with a psychotic disorder experience greater levels of loneliness than normative groups. However, the results also indicate that self-reported loneliness is not associated with social cognitive abilities or functional outcome in psychosis. Regression analyses indicate that roughly half the variance in loneliness endorsed by persons with SSDs is accounted for by clinical variables, with loneliness most strongly associated with guilt and self-esteem.

Conclusion

These findings suggest that treatments aiming to reduce perceived social isolation in psychosis should incorporate techniques to bolster selfesteem, reduce guilt, and improve depressive symptoms.

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Acknowledgements

This research was supported by Grant MH93432 to Drs. Harvey, Penn, and Pinkham from the National Institute of Mental Health. We would like to thank all individuals who participated in this investigation, including all research subjects and research assistants at the participating sites for their significant effort and contributions to the SCOPE study.

Author information

Authors and Affiliations

  1. Department of Psychology and Neuroscience, University of North Carolina, 235 E. Cameron Avenue, 258 Davie Hall, Chapel Hill, NC, 27599, USA

    Kelsey A. Ludwig & David L. Penn

  2. College of Social Work, The University of Utah, Salt Lake City, UT, USA

    Lana N. Nye

  3. Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA

    Grace L. Simmons

  4. Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Lars F. Jarskog

  5. School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA

    Amy E. Pinkham

  6. Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, USA

    Amy E. Pinkham

  7. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Philip D. Harvey

  8. Research Service, Miami VA Healthcare System, Miami, FL, USA

    Philip D. Harvey

  9. School of Psychology, Australian Catholic University, Melbourne, VIC, Australia

    David L. Penn

Authors
  1. Kelsey A. Ludwig
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  2. Lana N. Nye
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  3. Grace L. Simmons
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  4. Lars F. Jarskog
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  5. Amy E. Pinkham
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  7. David L. Penn
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Corresponding author

Correspondence to Kelsey A. Ludwig.

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Conflict of interest

Dr. Harvey has received consulting fees or travel reimbursements from Alkermes, Akili, Boehringer Ingelheim, Intra Cellular Therapies, Otsuka America, Sanofi Pharma, Sunovion Pharma, Takeda Pharma, and Teva Pharma during the past year. He has a research grant from Takeda and from the Stanley Medical Research Foundation. In the past 3 years, Dr. Jarskog has received research grant funding from NIH, Auspex/Teva, Boehringer-Ingelheim and Otsuka. The remaining authors declare that they have no conflict of interest pertinent to this study.

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Ludwig, K.A., Nye, L.N., Simmons, G.L. et al. Correlates of loneliness among persons with psychotic disorders. Soc Psychiatry Psychiatr Epidemiol 55, 549–559 (2020). https://doi.org/10.1007/s00127-019-01789-5

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  • DOI: https://doi.org/10.1007/s00127-019-01789-5

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