Loneliness is a frequent and distressing experience among people with mental health problems. However, few longitudinal studies have so far investigated the trajectories of loneliness and objective social isolation, and the extent to which both issues may impact mental health outcomes among mental health service users. Therefore, this study aims to describe the trajectories of loneliness and objective social isolation and their associations with self-rated personal recovery among people leaving crisis resolution teams (CRTs). A total of 224 participants receiving care from CRTs (recruited for a large multi-site randomised controlled trial) were included in this longitudinal cohort study. They completed the eight-item University of California at Los Angeles Loneliness Scale (ULS-8), Lubben-Social Network Scale (LNSN-6), and the Questionnaire about the Process of Recovery (QPR) (primary outcome) at baseline, 4- and 18-month follow-up, as well as baseline sociodemographic and clinical variables. We compared groups who were persistently lonely (at all time points), intermittently lonely (at one or two time points) and never lonely. After adjusting for all potential confounders and baseline predictive variables, persistent severe loneliness was associated with worse personal recovery at 18-month follow-up compared with the never lonely (reference group) (coef. = − 12.8, 95% CI -11.8, − 3.8, p < .001), as was being intermittently lonely (coef. = − 7.8, 95% CI -18.8, − 6.8, p < .001). The persistently objectively social isolated group (coef. = − 9.8, 95% CI -15.7, − 3.8, p = .001) also had poorer self-rated recovery at 18-month follow-up than those who were not socially isolated at any timepoint (i.e., reference category). Results suggest that both persistent loneliness and objective social isolation are associated with poorer self-rated recovery following a crisis, compatible with a causal relationship. These findings suggest a potential role for interventions aimed at alleviating loneliness and objective social isolation in improving recovery outcomes for people with mental health symptoms. Increased awareness of both issues among health practitioners is also warranted.

中文翻译：

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在英国二级心理健康服务用户队列中，孤独感和客观社会孤立的轨迹以及持续孤独感与自我报告的个人康复之间的关联

在有心理健康问题的人中，孤独是一种常见且令人痛苦的经历。然而，迄今为止，很少有纵向研究调查孤独和客观社会孤立的轨迹，以及这两个问题可能在多大程度上影响心理健康服务使用者的心理健康结果。因此，本研究旨在描述离开危机解决团队 (CRT) 的人的孤独和客观社会孤立的轨迹及其与自我评估个人恢复的关联。这项纵向队列研究共包括 224 名接受 CRT 治疗的参与者（为一项大型多中心随机对照试验招募）。他们完成了加州大学洛杉矶分校孤独量表 (ULS-8)、Lubben-社交网络量表 (LNSN-6)、以及关于基线、4 个月和 18 个月随访时的恢复过程 (QPR)（主要结果）以及基线社会人口学和临床变量的问卷。我们比较了持续孤独（在所有时间点）、间歇性孤独（在一个或两个时间点）和从不孤独的组。在对所有潜在混杂因素和基线预测变量进行调整后，与从不孤独的人（参考组）相比，持续的严重孤独与 18 个月随访时的个人恢复更差相关（系数 = - 12.8，95% CI -11.8， - 3.8，p < .001），因为间歇性孤独（coef. = − 7.8, 95% CI -18.8, − 6.8, p < .001）。持续客观的社会孤立群体 (coef. = − 9.8, 95% CI -15.7, − 3.8, p = . 001) 在 18 个月的随访中也比那些在任何时间点都没有与社会隔离的人（即参考类别）有更差的自我评估恢复。结果表明，持续的孤独和客观的社会孤立都与危机后较差的自我评估恢复有关，与因果关系相容。这些发现表明，旨在减轻孤独感和客观的社会孤立感的干预措施在改善有心理健康症状的人的康复结果方面具有潜在作用。还需要提高卫生从业人员对这两个问题的认识。这些发现表明，旨在减轻孤独感和客观的社会孤立感的干预措施在改善有心理健康症状的人的康复结果方面具有潜在作用。还需要提高卫生从业人员对这两个问题的认识。这些发现表明，旨在减轻孤独感和客观的社会孤立感的干预措施在改善有心理健康症状的人的康复结果方面具有潜在作用。还需要提高卫生从业人员对这两个问题的认识。