Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.
Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.
J Psychiatr Res. 2022 Oct;154:56-60. doi: 10.1016/j.jpsychires.2022.07.057. Epub 2022 Jul 31.
Though loneliness represents a public health concern, this complex unpleasant feeling is commonly neglected in psychiatric care and may constitute a new treatment target in clinical groups particularly prone to feeling lonely and socially isolated, e.g., persistent depressive disorder (PDD). Schema modes encompass a set of distinct cognitive-affective patterns that may contribute to loneliness and social isolation. Aim of this study was to examine the interplay between subjective loneliness and objective social network size with schema modes in patients with PDD as well as healthy controls (HC).
Sixty-two PDD patients (DSM-5; 35 female, M = 40.5, SD = 12.4) and 71 HC (60 female, M = 28.1, SD = 10.1) were assessed cross-sectionally using the following self-report measures: UCLA Loneliness Scale, Social Network Index (SNI), and Schema-Mode-Inventory, revised version (SMI-r). Correlational and multiple linear regression analyses were performed.
PDD patients reported significantly higher scores of loneliness and maladaptive schema modes and a smaller social network than HC. Loneliness was significantly positively associated with the modes Vulnerable Child, Detached Protector, Bully and Attack, and Punitive Parent, and negatively with Contented Child and Healthy Adult in both groups. In contrast, social network size was only positively associated with the Contented Child mode.
Loneliness is highly prevalent in PDD and in contrast to social network size associated with maladaptive schema modes. Therapeutically addressing these schema modes with specific techniques may represent a mechanism-based intervention for patients suffering from loneliness and should be investigated in clinical trials.
尽管孤独是一个公共卫生问题，但这种复杂的不愉快感觉在精神科护理中通常被忽视，并且可能成为临床群体中一个新的治疗目标，特别是那些容易感到孤独和社交孤立的群体，例如持续性抑郁障碍（PDD）。图式模式包含了一系列独特的认知情感模式，这些模式可能导致孤独和社交孤立。本研究的目的是探讨 PDD 患者和健康对照组（HC）中主观孤独感与客观社交网络大小与图式模式之间的相互作用。
62 名 PDD 患者（DSM-5；35 名女性，M=40.5，SD=12.4）和 71 名 HC（60 名女性，M=28.1，SD=10.1）被使用 UCLA 孤独感量表、社会网络指数（SNI）和修订版图式模式量表（SMI-r）进行横断面评估。进行了相关和多元线性回归分析。
PDD 患者报告的孤独感和适应不良的图式模式得分显著高于 HC，社交网络也较小。孤独感与脆弱儿童、独立保护者、欺凌者和攻击者、惩罚性父母模式呈显著正相关，与两组中的满足儿童和健康成年人模式呈显著负相关。相比之下，社交网络大小仅与满足儿童模式呈正相关。
孤独感在 PDD 中非常普遍，与社交网络大小相反，与适应不良的图式模式相关。用特定技术治疗这些图式模式可能是针对孤独感患者的基于机制的干预措施，应该在临床试验中进行研究。
