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

Abstract Aims 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 diso...

Full description

Saved in:
Bibliographic Details
Main Authors: André Hajek, Razak M. Gyasi, Supa Pengpid, Karl Peltzer, Karel Kostev, Pinar Soysal, Lee Smith, Louis Jacob, Nicola Veronese, Hans-Helmut König
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:Epidemiology and Psychiatric Sciences
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S2045796025000228/type/journal_article
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849724716533678080
author André Hajek
Razak M. Gyasi
Supa Pengpid
Karl Peltzer
Karel Kostev
Pinar Soysal
Lee Smith
Louis Jacob
Nicola Veronese
Hans-Helmut König
author_facet André Hajek
Razak M. Gyasi
Supa Pengpid
Karl Peltzer
Karel Kostev
Pinar Soysal
Lee Smith
Louis Jacob
Nicola Veronese
Hans-Helmut König
author_sort André Hajek
collection DOAJ
description Abstract Aims 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. Methods 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. Results 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%, I2 = 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. Conclusions 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.
format Article
id doaj-art-b1df0fa644234cfba7c60c413e1aa760
institution DOAJ
issn 2045-7960
2045-7979
language English
publishDate 2025-01-01
publisher Cambridge University Press
record_format Article
series Epidemiology and Psychiatric Sciences
spelling doaj-art-b1df0fa644234cfba7c60c413e1aa7602025-08-20T03:10:40ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792025-01-013410.1017/S2045796025000228Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysisAndré Hajek0https://orcid.org/0000-0002-6886-2745Razak M. Gyasi1https://orcid.org/0000-0002-6733-1539Supa Pengpid2https://orcid.org/0000-0002-7714-8869Karl Peltzer3https://orcid.org/0000-0002-5980-0876Karel Kostev4https://orcid.org/0000-0002-2124-7227Pinar Soysal5https://orcid.org/0000-0002-6042-1718Lee Smith6https://orcid.org/0000-0002-5340-9833Louis Jacob7https://orcid.org/0000-0003-1071-1239Nicola Veronese8https://orcid.org/0000-0002-9328-289XHans-Helmut König9https://orcid.org/0000-0001-5711-6862Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, GermanyAfrican Population and Health Research Center, Nairobi, Kenya Faculty of Health, National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, AustraliaDepartment of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, TaiwanDepartment of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand Department of Psychology, University of the Free State, Bloemfontein, South Africa Department of Psychology, College of Medical and Health Science, Asia University, Taichung, TaiwanUniversity Hospital Marburg, Philipps-University Marburg, Baldingerstraße, Marburg, GermanyDepartment of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, TurkiyeCentre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UKDepartment of Physical Medicine and Rehabilitation, AP-HP, Lariboisière-Fernand Widal Hospital, Université Paris Cité, Paris, France Université Paris Cité, INSERM U1153, CRESS, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, SpainDepartment of Medicine, Geriatric Unit, University of Palermo, Palermo, ItalyDepartment of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, GermanyAbstract Aims 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. Methods 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. Results 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%, I2 = 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. Conclusions 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. https://www.cambridge.org/core/product/identifier/S2045796025000228/type/journal_articlebipolar disorderlonelinessschizophreniaserious mental illnesssevere mental disordersocial isolation
spellingShingle André Hajek
Razak M. Gyasi
Supa Pengpid
Karl Peltzer
Karel Kostev
Pinar Soysal
Lee Smith
Louis Jacob
Nicola Veronese
Hans-Helmut König
Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysis
Epidemiology and Psychiatric Sciences
bipolar disorder
loneliness
schizophrenia
serious mental illness
severe mental disorder
social isolation
title Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysis
title_full Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysis
title_fullStr Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysis
title_full_unstemmed Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysis
title_short Prevalence of loneliness and social isolation amongst individuals with severe mental disorders: a systematic review and meta-analysis
title_sort prevalence of loneliness and social isolation amongst individuals with severe mental disorders a systematic review and meta analysis
topic bipolar disorder
loneliness
schizophrenia
serious mental illness
severe mental disorder
social isolation
url https://www.cambridge.org/core/product/identifier/S2045796025000228/type/journal_article
work_keys_str_mv AT andrehajek prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT razakmgyasi prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT supapengpid prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT karlpeltzer prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT karelkostev prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT pinarsoysal prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT leesmith prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT louisjacob prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT nicolaveronese prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis
AT hanshelmutkonig prevalenceoflonelinessandsocialisolationamongstindividualswithseverementaldisordersasystematicreviewandmetaanalysis