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孤独严重程度在不同心理健康诊断组之间有何差异:一项横断面研究。

To what extent does severity of loneliness vary among different mental health diagnostic groups: A cross-sectional study.

机构信息

Division of Psychiatry, University College London, London, UK.

Population Health Research Institute, St George's University of London, London, UK.

出版信息

Int J Ment Health Nurs. 2020 Oct;29(5):921-934. doi: 10.1111/inm.12727. Epub 2020 Apr 30.

Abstract

Loneliness is a common and debilitating problem in individuals with mental health disorders. However, our knowledge on severity of loneliness in different mental health diagnostic groups and factors associated with loneliness is poor, thus limiting the ability to target and improve loneliness interventions. The current study investigated the association between diagnoses and loneliness and explored whether psychological and social factors were related to loneliness. This study employed a cross-sectional design using data from a completed study which developed a measure of social inclusion. It included 192 participants from secondary, specialist mental health services with a primary diagnosis of psychotic disorders (n = 106), common mental disorders (n = 49), or personality disorders (n = 37). The study explored differences in loneliness between these broad diagnostic groups, and the relationship to loneliness of: affective symptoms, social isolation, perceived discrimination, and internalized stigma. The study adhered to the STROBE checklist for observational research. People with common mental disorders (MD = 3.94, CI = 2.15 to 5.72, P < 0.001) and people with personality disorders (MD = 4.96, CI = 2.88 to 7.05, P < 0.001) reported higher levels of loneliness compared to people with psychosis. These differences remained significant after adjustment for all psychological and social variables. Perceived discrimination and internalized stigma were also independently associated with loneliness and substantially contributed to a final explanatory model. The severity of loneliness varies between different mental health diagnostic groups. Both people with common mental disorders and personality disorders reported higher levels of loneliness than people with psychosis. Addressing perceived mental health discrimination and stigma may help to reduce loneliness.

摘要

孤独感是心理健康障碍患者中常见且令人衰弱的问题。然而,我们对不同心理健康诊断群体中孤独感的严重程度以及与孤独感相关的因素知之甚少,这限制了我们针对和改善孤独感干预的能力。本研究调查了诊断与孤独感之间的关系,并探讨了心理和社会因素是否与孤独感有关。本研究采用横断面设计,使用一项已完成的研究的数据,该研究开发了一种社会包容度的衡量标准。研究纳入了来自二级和专科精神卫生服务机构的 192 名参与者,他们的主要诊断为精神病性障碍(n=106)、常见精神障碍(n=49)或人格障碍(n=37)。研究探讨了这些广泛的诊断群体之间孤独感的差异,以及与孤独感相关的因素:情感症状、社会隔离、感知歧视和内化污名。该研究遵循 STROBE 观察性研究清单。与患有精神病的人相比,患有常见精神障碍(MD=3.94,CI=2.15 至 5.72,P<0.001)和人格障碍(MD=4.96,CI=2.88 至 7.05,P<0.001)的人报告了更高水平的孤独感。在调整所有心理和社会变量后,这些差异仍然显著。感知歧视和内化污名也与孤独感独立相关,并对最终的解释模型有很大贡献。孤独感的严重程度在不同的心理健康诊断群体之间有所不同。患有常见精神障碍和人格障碍的人比患有精神病的人报告了更高水平的孤独感。解决感知到的心理健康歧视和污名将有助于减少孤独感。

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