See the published version of this article at BMC Psychiatry.
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Research article
Theodora Stefanidou
University College London
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3172-2685
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Psychiatry.
Background: Loneliness is an important public health problem with established adverse effects on physical and mental health. Although, people with psychosis often experience high levels of loneliness, relatively little is known about the relationship between loneliness and early psychosis. Potential interventions to address loneliness might be easier to implement early in the illness when social networks and social skills may be more intact than at a later stage. We investigated the views of mental health practitioners about the context and causes of loneliness in people with early psychosis, and about potential interventions.
Methods: Semi-structured face-to-face interviews were conducted with mental health practitioners (n=20). Participants were purposively recruited from four early intervention services for first-episode psychosis in the UK. Interviews were transcribed verbatim and thematic analysis was conducted.
Results: Participants believed that the majority of service users with early psychosis experience feelings of loneliness. They often saw socially isolated and disconnected clients and believed them to be lonely, but rarely discussed loneliness explicitly in clinical interactions. A combination of symptoms, stigma and negative sense of self were believed to underpin loneliness. Participants could not identify any specific current interventions delivered by their services for tackling loneliness, but thought some routinely provided interventions, including social groups and psychological treatments, could be helpful. They favoured making a wider range of loneliness interventions available and believed that community agencies beyond mental health services should be involved to make these effective and feasible to deliver. They suggested social participation interventions without an explicit mental health focus as potentially promising and valued a co-produced approach to intervention development.
Conclusions: This study suggests that loneliness is not routinely discussed in early intervention services, and a targeted strategy for tackling it is lacking. Co-produced, individualised community approaches, and interventions that target symptoms, stigma and negative self-schemas might be beneficial in alleviating loneliness for people with early psychosis. Empirical research is needed to develop and test such interventions.
Keywords
Loneliness, early psychosis, mental health practitioners, qualitative research
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CURRENT STATUS: Published
Version 1
Posted 13 Aug, 2020
Published
On 06 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 18 Jan, 2021
Review #3 received
Received 17 Jan, 2021
Reviewer #3 agreed
On 03 Jan, 2021
Review #2 received
Received 13 Dec, 2020
Review #1 received
Received 28 Aug, 2020
Reviewer #2 agreed
On 27 Aug, 2020
Editor assigned
On 14 Aug, 2020
Reviewers invited
Invitations sent on 14 Aug, 2020
Reviewer #1 agreed
On 14 Aug, 2020
Submission checks complete
On 12 Aug, 2020
Editor invited
On 11 Aug, 2020
First submitted
On 29 Jul, 2020
Metrics
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PDF Downloads: ...
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This preprint is under consideration at BMC Psychiatry. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Theodora Stefanidou
University College London
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3172-2685
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 13 Aug, 2020
Published
On 06 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 18 Jan, 2021
Review #3 received
Received 17 Jan, 2021
Reviewer #3 agreed
On 03 Jan, 2021
Review #2 received
Received 13 Dec, 2020
Review #1 received
Received 28 Aug, 2020
Reviewer #2 agreed
On 27 Aug, 2020
Editor assigned
On 14 Aug, 2020
Reviewers invited
Invitations sent on 14 Aug, 2020
Reviewer #1 agreed
On 14 Aug, 2020
Submission checks complete
On 12 Aug, 2020
Editor invited
On 11 Aug, 2020
First submitted
On 29 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Psychiatry.
Background: Loneliness is an important public health problem with established adverse effects on physical and mental health. Although, people with psychosis often experience high levels of loneliness, relatively little is known about the relationship between loneliness and early psychosis. Potential interventions to address loneliness might be easier to implement early in the illness when social networks and social skills may be more intact than at a later stage. We investigated the views of mental health practitioners about the context and causes of loneliness in people with early psychosis, and about potential interventions.
Methods: Semi-structured face-to-face interviews were conducted with mental health practitioners (n=20). Participants were purposively recruited from four early intervention services for first-episode psychosis in the UK. Interviews were transcribed verbatim and thematic analysis was conducted.
Results: Participants believed that the majority of service users with early psychosis experience feelings of loneliness. They often saw socially isolated and disconnected clients and believed them to be lonely, but rarely discussed loneliness explicitly in clinical interactions. A combination of symptoms, stigma and negative sense of self were believed to underpin loneliness. Participants could not identify any specific current interventions delivered by their services for tackling loneliness, but thought some routinely provided interventions, including social groups and psychological treatments, could be helpful. They favoured making a wider range of loneliness interventions available and believed that community agencies beyond mental health services should be involved to make these effective and feasible to deliver. They suggested social participation interventions without an explicit mental health focus as potentially promising and valued a co-produced approach to intervention development.
Conclusions: This study suggests that loneliness is not routinely discussed in early intervention services, and a targeted strategy for tackling it is lacking. Co-produced, individualised community approaches, and interventions that target symptoms, stigma and negative self-schemas might be beneficial in alleviating loneliness for people with early psychosis. Empirical research is needed to develop and test such interventions.
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