Hajek André, Gyasi Razak M, Pengpid Supa, Peltzer Karl, Kostev Karel, Soysal Pinar, Smith Lee, Jacob Louis, Veronese Nicola, König Hans-Helmut
Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
African Population and Health Research Center, Nairobi, Kenya.
Epidemiol Psychiatr Sci. 2025 Apr 15;34:e25. doi: 10.1017/S2045796025000228.
A systematic review and meta-analysis was conducted to investigate the prevalence and antecedents/outcomes of loneliness and social isolation among individuals with severe mental disorders (SMD), such as schizophrenia, schizoaffective disorder, bipolar disorder or major depressive disorder.
Five well-known electronic databases (PubMed, PsycINFO, CINAHL, Web of Science and Scopus) were searched (plus a hand search). Observational studies that report the prevalence and, if available, antecedents and consequences of loneliness/isolation among individuals with SMD were included. Key characteristics were extracted, and a meta-analysis was performed. Our systematic review was preregistered on PROSPERO (ID: CRD42024559043). The PRISMA guidelines were followed. The Joanna Briggs Institute (JBI) standardized critical appraisal tool developed for prevalence studies was applied to assess the quality of the included studies.
The initial search yielded 4506 records, and after duplicate removal and screening, a total of 10 studies were finally included. The studies included used data from Europe, Asia, North America, and Oceania. Two studies employed a longitudinal design, while all other studies had a cross-sectional design. Most of the studies included between 100 and 500 individuals with SMD. All studies involved both male and female participants, with women typically comprising about 40% of the sample. The average age of participants often ranged from approximately 30 to 40 years. The estimated prevalence of loneliness was 59.1% (95% CI: 39.6% to 78.6%, = 99.3, < .001) among individuals with any diagnosis of SMD. Furthermore, the estimated prevalence of objective social isolation was 63.0% (95% CI: 58.6% to 67.4%) among individuals with schizophrenia or schizophrenia spectrum disorder. The quality of the studies was moderate to good. Subjective well-being and depressive symptoms in particular were found to contribute to loneliness in the included studies.
The present systematic review with meta-analysis identified high levels of loneliness and objective social isolation among those with SMD. These findings stress the importance of monitoring and addressing social needs in this vulnerable group, which may have a positive effect on the life quality of individuals with SMD. Future research in neglected regions (e.g. South America and Africa) is recommended. Different diagnoses within severe mental disorders should be distinguished in future studies. Furthermore, additional longitudinal studies are required to explore the antecedents and consequences of loneliness and social isolation among individuals with SMD.
进行一项系统评价和荟萃分析，以调查精神分裂症、分裂情感性障碍、双相情感障碍或重度抑郁症等严重精神障碍（SMD）患者中孤独感和社会隔离的患病率及其前驱因素/后果。
检索了五个著名的电子数据库（PubMed、PsycINFO、CINAHL、Web of Science和Scopus）（并进行了手工检索）。纳入报告SMD患者孤独感/隔离的患病率以及（若有）前驱因素和后果的观察性研究。提取关键特征并进行荟萃分析。我们的系统评价已在PROSPERO上预先注册（注册号：CRD42024559043）。遵循PRISMA指南。应用乔安娜·布里格斯研究所（JBI）为患病率研究开发的标准化批判性评价工具来评估纳入研究的质量。
初步检索得到4506条记录，经过去重和筛选后，最终共纳入10项研究。纳入的研究使用了来自欧洲、亚洲、北美洲和大洋洲的数据。两项研究采用纵向设计，而所有其他研究均为横断面设计。大多数研究纳入了100至500名SMD患者。所有研究均涉及男性和女性参与者，女性通常约占样本的40%。参与者的平均年龄通常在30至40岁左右。在任何诊断为SMD的患者中，孤独感的估计患病率为59.1%（95%置信区间：39.6%至78.
