Badcock Johanna C, Shah Sonal, Mackinnon Andrew, Stain Helen J, Galletly Cherrie, Jablensky Assen, Morgan Vera A
Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia; Cooperative Research Centre - Mental Health, Barry Street, Carlton, Victoria 3052, Australia.
Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia.
Schizophr Res. 2015 Dec;169(1-3):268-273. doi: 10.1016/j.schres.2015.10.027. Epub 2015 Oct 31.
Loneliness involves subjective, rather than objective, social isolation and has a range of negative effects on mental and physical functioning. The purpose of this study was to examine the prevalence of loneliness in psychotic disorders and its association with symptoms and cognitive performance.
Data were drawn from the second Australian National Survey of Psychosis and comprised responses from 1642 participants with an International Classification of Diseases 10 diagnosis of psychotic disorder who had completed a semi-structured interview of symptoms and social functioning (including loneliness), along with standardized assessments of current (digit symbol coding; DSC) and premorbid (National Adult Reading Test) cognitive ability. We examined the prevalence of loneliness across the diagnostic categories of psychosis, and its association with psychotic and non-psychotic symptoms and digit symbol coding scores.
The prevalence of loneliness was high, ranging from 74.75% in participants with delusional disorders to 93.8% in depressive psychosis, and was significantly higher than in the general population. Loneliness was also significantly associated with anhedonia and subjective thought disorder. Participants feeling socially isolated/lonely for company had significantly lower DSC scores than those who only felt lonely occasionally. Unexpectedly, participants who reported not feeling lonely had the lowest DSC scores.
Loneliness is common across all psychotic disorders, particularly in depressive psychosis. It is specifically associated with ongoing loss of pleasure and disordered thoughts as well as impairment in current cognitive functioning. However, poor cognitive functioning is not inevitably associated with loneliness. Implications for personalized treatment of psychosis are discussed.
孤独涉及主观而非客观的社会隔离，对心理和身体机能有一系列负面影响。本研究旨在调查精神病性障碍中孤独的患病率及其与症状和认知表现的关联。
数据取自第二次澳大利亚全国精神病调查，包括1642名参与者的回答，这些参与者根据国际疾病分类第10版被诊断为患有精神病性障碍，他们完成了关于症状和社会功能（包括孤独感）的半结构化访谈，以及对当前（数字符号编码；DSC）和病前（国家成人阅读测试）认知能力的标准化评估。我们研究了精神病各诊断类别中孤独的患病率，以及它与精神病性和非精神病性症状及数字符号编码分数的关联。
孤独感的患病率很高，从妄想性障碍患者中的74.75%到抑郁性精神病患者中的93.8%不等，且显著高于一般人群。孤独感还与快感缺失和主观思维障碍显著相关。因陪伴而感到社交孤立/孤独的参与者的DSC分数显著低于那些只是偶尔感到孤独的参与者。出乎意料的是，报告没有感到孤独的参与者的DSC分数最低。
孤独在所有精神病性障碍中都很常见，尤其是在抑郁性精神病中。它与持续的快感缺失、思维紊乱以及当前认知功能受损具体相关。然而，认知功能差并非必然与孤独相关。文中讨论了对精神病个性化治疗的启示。
