How does loneliness interact with positive, negative and depressive symptoms of psychosis? New insights from a longitudinal therapy process study.

Autor: Winkler K; Universität Hamburg, Institute of Psychology, Clinical Psychology and Psychotherapy, Von-Melle-Park 5, 20146 Hamburg, Germany. Electronic address: katharina.winkler@uni-hamburg.de., Lincoln TM; Universität Hamburg, Institute of Psychology, Clinical Psychology and Psychotherapy, Von-Melle-Park 5, 20146 Hamburg, Germany., Wiesjahn M; Philipps-University Marburg, Department of Psychology, Clinical Psychology and Psychotherapy, Gutenbergstraße 18, 35032 Marburg, Germany., Jung E; Philipps-University Marburg, Department of Psychology, Clinical Psychology and Psychotherapy, Gutenbergstraße 18, 35032 Marburg, Germany., Schlier B; Universität Hamburg, Institute of Psychology, Clinical Psychology and Psychotherapy, Von-Melle-Park 5, 20146 Hamburg, Germany; University of Wuppertal, Institute of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy, Gaußstraße 20, 42119 Wuppertal, Germany.
Jazyk: angličtina
Zdroj: Schizophrenia research [Schizophr Res] 2024 Sep; Vol. 271, pp. 179-185. Date of Electronic Publication: 2024 Jul 22.
DOI: 10.1016/j.schres.2024.07.024
Abstrakt: Cross-sectional research suggests an association between loneliness and psychotic symptoms, but the causal direction of this association is still unclear. Even though loneliness has been proposed as a potential treatment target to improve psychotherapy for psychosis, not much is known about its role in the treatment process. In this study, we re-analyzed data from a therapy process study to investigate the temporal dynamics between loneliness and psychotic symptoms throughout therapy and to explore whether state-of-the-art CBT for psychosis (CBTp) decreases loneliness. Over the course of up to 45 weekly sessions of CBTp, 57 patients reported their feelings of loneliness and current positive, negative and depressive symptom levels at each session. Multilevel regression revealed a reduction in all symptoms over time, but no reduction in loneliness. Time-lagged multilevel regression showed that loneliness predicted subsequent negative and depressive symptoms, whereas positive symptom levels predicted subsequent loneliness. Thus, changes in loneliness seem to be both cause and consequence of psychotic symptom changes. These findings highlight the importance of loneliness as a treatment target, particularly in patients with negative symptoms and depression. Future research should address loneliness-specific interventions as an augmentation of state-of-the-art CBTp.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: T.M. Lincoln has published German language manuals on CBT for psychosis.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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