Loneliness in psychosis: a systematic review

  • Michelle H. LimEmail author
  • John F. M. Gleeson
  • Mario Alvarez-Jimenez
  • David L. Penn



The aim of the review is to understand the relationships between loneliness and related psychological and social factors in individuals with psychosis. Loneliness is poorly understood in people with psychosis. Given the myriad of social challenges facing individuals with psychosis, these findings can inform psychosocial interventions that specifically target loneliness in this vulnerable group.


We adhered to the PRISMA guidelines and systematically reviewed empirical studies that measured loneliness either as a main outcome or as an associated variable in individuals with psychosis.


A total of ten studies examining loneliness in people diagnosed with a psychotic disorder were examined. Heterogeneity in the assessment of loneliness was found, and there were contradictory findings on the relationship between loneliness and psychotic symptomatology. In individuals with psychosis, loneliness may be influenced by psychological and social factors such as increased depression, psychosis, and anxiety, poor social support, poor quality of life, more severe internalised stigma and perceived discrimination, and low self-esteem.


The relationship between loneliness and psychosis remains poorly understood due to a lack of rigorous studies. Although having strong social relationships is crucial to facilitate recovery from serious mental illness, psychosocial interventions that specifically target loneliness in individuals with psychosis are lacking and sorely needed. Interventions targeting loneliness in those with psychosis will also need to account for additional barriers associated with psychosis (e.g., social skill deficits, impoverished social networks, and negative symptoms).


Loneliness Perceived social isolation Psychosis Systematic review 



We thank Dr. Robert Eres for the manuscript review.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interests.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Michelle H. Lim
    • 1
    Email author
  • John F. M. Gleeson
    • 2
  • Mario Alvarez-Jimenez
    • 3
    • 4
  • David L. Penn
    • 2
    • 5
  1. 1.Centre for Mental HealthSwinburne University of TechnologyHawthornAustralia
  2. 2.School of PsychologyAustralian Catholic UniversityMelbourneAustralia
  3. 3.Orygen, The National Centre of Excellence in Youth Mental HealthParkvilleAustralia
  4. 4.Centre for Youth Mental HealthThe University of MelbourneParkvilleAustralia
  5. 5.Department of Psychology and NeuroscienceUniversity of North Carolina, Chapel HillChapel HillUSA

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