Loneliness in patients with schizophrenia

Background: The treatment goals for patients with schizophrenia are to address subjective well-being, quality of life, and recovery in recent decades. Loneliness is a negative subjective feeling and related to social isolation, which is thought to be a barrier to recovery. Few research exist to study loneliness in-depth in patients with schizophrenia. Methods: In this review, the authors intend to address the issues of the prevalence, the impacts, the associated factors, and the interventions of loneliness in patients with schizophrenia. Results: Studies showed that patients with schizophrenia have a greater degree of loneliness than those without. The physical and mental health problems associated with loneliness in patients with schizophrenia include hypertension, high blood level of glycated hemoglobin, activated hypothalamus–pituitary–adrenal axis, poor subjective quality of life, depression, anxiety, suicide, use of addictive substances, high perceived stress, low self-esteem, low sense of pleasure, pessimism, and low resilience. From an ecological approach, loneliness in patients with schizophrenia is associated with several personal disease factors, personal cognitive factors, personal socioeconomic factors, community integration, and residence. Social prescribing projects, cognitive behavioral therapy, mindfulness, and positive psychology interventions have been used to reduce loneliness in patients with schizophrenia. Conclusion: Loneliness is an important indicator of the physical and mental health in patients with schizophrenia. Several factors associated with loneliness in patients with schizophrenia have been identified in the past studies. Further intervention research are required for establish effective methods to reduce loneliness in patients with schizophrenia.