Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysis.

Publication date: Apr 15, 2025

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%, I = 99. 3, P < .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.

Concepts Keywords
Africa Bipolar Disorder
Crd42024559043 bipolar disorder
Databases Depressive Disorder, Major
Oceania Humans
Schizophrenia Loneliness
loneliness
Mental Disorders
Prevalence
Psychotic Disorders
Schizophrenia
schizophrenia
serious mental illness
severe mental disorder
Social Isolation
social isolation

Semantics

Type Source Name
disease MESH loneliness
disease MESH severe mental disorders
disease MESH schizophrenia
disease MESH schizoaffective disorder
disease MESH bipolar disorder
disease MESH major depressive disorder
disease MESH depressive symptoms

Original Article

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Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysis.

Publication date: Apr 15, 2025

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%, I = 99. 3, P < .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.

Concepts Keywords
Africa Bipolar Disorder
Crd42024559043 bipolar disorder
Databases Depressive Disorder, Major
Oceania Humans
Schizophrenia Loneliness
loneliness
Mental Disorders
Prevalence
Psychotic Disorders
Schizophrenia
schizophrenia
serious mental illness
severe mental disorder
Social Isolation
social isolation

Semantics

Type Source Name
disease MESH loneliness
disease MESH severe mental disorders
disease MESH schizophrenia
disease MESH schizoaffective disorder
disease MESH bipolar disorder
disease MESH major depressive disorder
disease MESH depressive symptoms

Original Article

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