Abstract
Loneliness disproportionately affects people with mental disorders, but associations with mental health outcomes in groups affected remain less well understood.
Method
A cohort of patients receiving mental healthcare on 30th June 2012 was assembled from a large mental health records database covering a south London catchment area. Recorded loneliness within the preceding 2 years was extracted using natural language processing and outcomes were measured between 30th June 2012 until 30th December 2019, except for survival which applied a censoring point of 6th December 2020 according to data available at the time of extraction. The following mental healthcare outcomes: (i) time to first crisis episode; (ii) time to first emergency presentation; (iii) all-cause mortality; (iv) days active to service per year; and (v) face-to-face contacts per year.
Results
Loneliness was recorded in 4,483 (16.7%) patients in the study population and fully adjusted models showed associations with subsequent crisis episode (HR 1.17, 95% CI 1.07–1.29), emergency presentation (HR 1.30, 1.21–1.40), days active per year (IRR 1.04, 1.03–1.05), and face-to-face contacts per year (IRR 1.28, 1.27–1.30). Recorded loneliness in patients with substance misuse problems was particularly strongly associated with adverse outcomes, including risk of emergency presentation (HR 1.68, 1.29–2.18) and mortality (HR 1.29, 1.01–1.65).
Conclusion
Patients receiving mental healthcare who are recorded as lonely have a higher risk of several adverse outcomes which may require a need for higher service input.
| Original language | English |
|---|---|
| Pages (from-to) | 2155-2164 |
| Number of pages | 10 |
| Journal | Social psychiatry and psychiatric epidemiology |
| Volume | 59 |
| Issue number | 12 |
| Early online date | 15 Apr 2024 |
| DOIs | |
| Publication status | Published (in print/issue) - Dec 2024 |
Bibliographical note
Publisher Copyright:© The Author(s) 2024.
Funding
MP carried out this work while studying for MSc in Mental Health Studies at Institute of Psychiatry, Psychology and Neuroscience at King\u2019s College London. The data resource, GP and RS are funded by the NIHR Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King\u2019s College London, and RS additionally by: (i) the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King\u2019s College Hospital NHS Foundation Trust; (ii) UKRI \u2013 Medical Research Council through the DATAMIND HDR UK Mental Health Data Hub (MRC reference: MR/W014386); (iii) the UK Prevention Research Partnership (Violence, Health and Society; MR-VO49879/1), an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
| Funders | Funder number |
|---|---|
| King's College London | |
| King's College Hospital NHS Foundation Trust | |
| Medical Research Council | MR/W014386 |
| MR-VO49879/1 |
Keywords
- Contacts with mental health services
- Loneliness
- Mortality
- Mental disorders
- Crisis episode
