Sex differences in loneliness, social isolation, and their impact on psychiatric symptoms and cognitive functioning in schizophrenia.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Loneliness*/psychology ; Social Isolation*/psychology ; Schizophrenia*/complications ; Schizophrenic Psychology*; Humans ; Female ; Male ; Adult ; Middle Aged ; Cognition ; Sex Factors ; Neuropsychological Tests ; Psychiatric Status Rating Scales

Background: Social isolation and loneliness, objective and subjective features of dysfunctional social relationships, are more prevalent in patients with schizophrenia (SCZ) than in the general population. This study aimed to explore sex differences in loneliness and social isolation among Chinese chronic SCZ patients, and to investigate their relationships with psychiatric symptoms and cognitive functioning.
Methods: A total of 323 SCZ patients, comprising 136 males and 187 females, were recruited. Psychopathology, cognitive functioning, loneliness, social isolation were assessed using the Positive and Negative Syndrome Scale (PANSS), the Repeated Battery for Assessment of Neuropsychological Status (RBANS), the UCLA (University of California, Los Angeles) Loneliness Scale (Version 3) and the Social Isolation Index (ISI). Multiple linear regression models were conducted to test the independent, relative, and synergistic efects of loneliness and social isolation on psychiatric symptoms and cognitive performance for male and female patients separately.
Results: Male patients exhibited higher UCLA loneliness scale scores and social isolation scores compared to female patients (p s < 0.05). In male patients, both loneliness and social isolation significantly predicted PANSS total scores (p s < 0.01), negative subscale scores (p s < 0.05) and general psychopathology subscale scores (p s < 0.05). For female patients, loneliness (not social isolation) significantly predicted immediate memory (p < 0.001), language (p = 0.013), delayed memory (p = 0.017), and RBANS total scores (p = 0.002). Further examination of loneliness components in female patients revealed that personal feelings of isolation were negatively associated with language (r = -0.21, p = 0.001) and a negative correlation exists between lack of collective connectedness and delayed memory (r = -0.19, p = 0.048).
Conclusion: Loneliness and social isolation are more pronounced in male SCZ patients than in female patients. Both loneliness and social isolation are positively related to psychiatric symptoms in male patients, while loneliness is negatively associated with cognitive functioning in female patients.
Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol received approval from the Institutional Review Board of Tianjin Anding Hospital (ID: 2022-09), and all participants provided written informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)

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2022KJ265 Tianjin Municipal Education Commission Scientific Research Program Project; 82371512 National Natural Science Foundation of China; TJYXZDXK-033A Tianjin Key Medical Discipline (Specialty) Construction Project; TJWJ2021QN064 Foundation of Tianjin Health Commission for Young Scholars

Keywords: Cognitive functioning; Loneliness; Psychiatric symptom; Schizophrenia; Social isolation

Date Created: 20241206 Date Completed: 20241206 Latest Revision: 20241209

20241210

PMC11622478

10.1186/s12888-024-06333-7

39643870