Lived experience of loneliness in psychosis: A qualitative approach

Abstract

Background

Loneliness impedes recovery from mental illness. Despite increased interest in loneliness in psychosis, qualitative methods are underused in clinical research on this topic.

Aims

We used qualitative interviews to explore loneliness among persons with schizophrenia spectrum disorders (SSDs). We examined which aspects of living with psychosis were associated with the experience of loneliness, including symptomatology, social relationships, and disruptions in school/work.

Methods

Sixteen participants diagnosed with SSDs engaged in semi-structured, qualitative interviews about loneliness. Participants commented on current activities and social relationships, including their perceptions of the quantity, quality and types of relationships. Important demographic and clinical information was acquired through communication with participants and/or through medical record review. Thematic analysis was used to examine interview content.

Results

Our analyses revealed four key topic areas and several sub-themes related to loneliness across participants, including aspects of the physical environment (e.g. financial limitations), social context (e.g. lacking a romantic partner), and psychological functioning (e.g. psychotic/symptoms) that impact lonely feelings. Participants commented on coping strategies to manage loneliness and provided suggestions for possible interventions.

Conclusions

Persons diagnosed with SSDs report significant and impactful feelings of loneliness. This study highlights the need for novel and effective treatments targeting loneliness in this population.

Keywords:

• Loneliness
• social isolation
• schizophrenia
• social relationships
• qualitative interviews

Acknowledgments

This research was supported by Author 5’s Linda Wagner-Martin Distinguished Professorship Fund provided through the College of Arts and Sciences at the University of North Carolina at Chapel Hill. We would like to thank all individuals who participated in this investigation, including all research participants for providing such thoughtful and insightful narratives about their experiences with loneliness.

Ethical approval

The study design, materials and procedure were reviewed and approved by the Institutional Review Board at the University of North Carolina at Chapel Hill before participants were recruited for the study. IRB Study #18-3238.

Disclosure statement

The authors declare that they have no conflict of interest pertinent to this study.

Additional information

Funding

The present work was financially supported by the Linda Wagner-Martin Distinguished Professorship Fund.