Coppola Andrea M, McDonald Jerry, Jimenez Amy M, Cao Jin, Shao Lucy, Xue Yijia, Zhang Bowei, Valmadrid Luke C, Eyler Lisa, Tu Xin M, Lee Ellen E
Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
VA San Diego Healthcare System, San Diego, California, USA.
Can J Psychiatry. 2025 Jul 28:7067437251355636. doi: 10.1177/07067437251355636.
ObjectiveLoneliness - distress that arises from discrepancies between perceived and desired relationships - is increasingly prevalent and recognized as a major public health concern due to the association with negative health outcomes. People living with schizophrenia (PLWS) experience higher rates of loneliness than the general population and may be particularly vulnerable to these adverse outcomes. In the general population, loneliness fluctuates throughout the lifespan, but the relationship between loneliness and age in PLWS is not well understood.Method271 adults, 141 adults with a diagnosis of schizophrenia or schizoaffective disorder (PLWS)and 130 adults with no history of major psychiatric illness (NCs) aged 27-69 completed clinical interviews and self-report measures assessing loneliness, perceived social support, and mental and physical health. Participants also completed blood draws for biomarkers of inflammation and hyperglycaemia. Locally Weighted Scatterplot Smoothing (LOWESS) regression modelling was used to examine potential non-linear relationships between loneliness and age for both groups and to select the polynomial that best fit the observed relationship.ResultsWe observed an age by diagnostic group interaction (log estimate = -0.005, SE = 0.003) such that PLWS reported higher loneliness scores compared to NCs of similar age. Patterns of loneliness differed with age between diagnostic groups such that loneliness remained relatively stable and high for PLWS while for NCs loneliness increased from age 40 to age 60. In both groups, loneliness was associated with worse self-reported physical health, depression, and, among PLWS, positive symptoms.ConclusionResults suggest different patterns of loneliness across adulthood for PLWS and NC, reflecting the different social milestones for NCs during this age period that are not as commonly experienced by PLWS, such as marriage, empty nesting and retirement. Loneliness is linked with poor physical and mental health outcomes among PLWS and may be an important target for improving morbidity and mortality for PLWS.
目的
孤独感——因感知到的人际关系与期望的人际关系之间存在差异而产生的痛苦——日益普遍,并且由于与负面健康结果相关联,被公认为是一个重大的公共卫生问题。精神分裂症患者(PLWS)比普通人群经历更高程度的孤独感,并且可能特别容易受到这些不良后果的影响。在普通人群中,孤独感在整个生命周期中波动,但PLWS中孤独感与年龄之间的关系尚未得到充分理解。
方法
271名年龄在27 - 69岁之间的成年人,其中141名被诊断患有精神分裂症或分裂情感性障碍的成年人(PLWS)以及130名无重大精神疾病史的成年人(NCs)完成了临床访谈以及评估孤独感、感知到的社会支持以及身心健康的自我报告测量。参与者还进行了血液抽取以检测炎症和高血糖的生物标志物。使用局部加权散点图平滑(LOWESS)回归模型来检验两组中孤独感与年龄之间潜在的非线性关系,并选择最符合观察到的关系的多项式。
结果
我们观察到一个诊断组与年龄的交互作用(对数估计值 = -0.005,标准误 = 0.003),使得与年龄相仿的NCs相比,PLWS报告的孤独感得分更高。诊断组之间孤独感的模式随年龄不同而有所差异,PLWS的孤独感相对稳定且较高,而NCs的孤独感从40岁到60岁有所增加。在两组中,孤独感都与自我报告的较差身体健康、抑郁相关,并且在PLWS中还与阳性症状相关。
结论
结果表明PLWS和NCs在成年期孤独感的模式不同,这反映了NCs在这个年龄段经历的不同社会里程碑,而PLWS通常不会经历这些,如结婚、空巢和退休。孤独感与PLWS的身心健康不良结果相关,并且可能是改善PLWS发病率和死亡率的一个重要目标。