The associations between daily reports of loneliness and psychotic experiences in the early risk stages for psychosis

Esdras Raposo de Almeida; Sara van der Tuin; Merel K Muller; David van den Berg; Yuan-Pang Wang; Wim Veling; Sanne H Booij; Johanna T W Wigman

doi:10.1111/eip.13537

The associations between daily reports of loneliness and psychotic experiences in the early risk stages for psychosis

Early Interv Psychiatry. 2024 Apr 25. doi: 10.1111/eip.13537. Online ahead of print.

Authors

Esdras Raposo de Almeida^{1

2}, Sara van der Tuin¹, Merel K Muller¹, David van den Berg^{3

4}, Yuan-Pang Wang², Wim Veling⁵, Sanne H Booij¹, Johanna T W Wigman¹

Affiliations

¹ Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
² Institute & Department of Psychiatry (LIM-23), Hospital das Clinicas, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
³ Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.
⁴ Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
⁵ University Center of Psychiatry, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

PMID: 38661051
DOI: 10.1111/eip.13537

Abstract

Aim: Bi-directional associations between loneliness and psychotic experiences (PEs) have been reported, but the mechanisms underlying these associations are unknown. This study aims to explore associations between daily reports of loneliness and PEs, and test differences in this association across young adult individuals at different levels of risk for psychosis.

Methods: We analysed 90-day diary data on loneliness and PEs from N = 96 participants (mean age 24.7, range 18-35, 77% female) divided into 4 subgroups, each indexing increased levels of risk for psychosis according to the clinical staging model: 'psychometric' (n = 25), 'low' (n = 27), 'mild' (n = 24), and 'ultra-high'(n = 20) risk. Multilevel vector autoregressive models examined within-day (contemporaneous) and between-day (temporal) associations between loneliness and PEs for the total sample. Next, these associations were compared across subgroups.

Results: Loneliness and PEs were significantly associated contemporaneously (partial correlation B = 0.14) but not temporally. Subgroup membership moderated both contemporaneous and temporal associations. The contemporaneous association between loneliness and PEs was stronger in the low-risk subgroup compared to the mild-risk (B = -0.35, p < .01) and ultra-high-risk (B = -0.36, p < .01) subgroups. The temporal association between loneliness on the previous day and PEs on the current day was stronger in mild-risk subgroup compared to the ultra-high-risk subgroup (B = -0.03, p = .03). After adjusting for multiple testing, only the contemporaneous-but not the temporal-associations remained statistically significant.

Conclusions: Loneliness is associated with PEs in individuals at risk for psychosis, particularly in those with low to mild symptoms. Our findings tentatively suggest that especially individuals with low expressions of PEs may be more sensitive to social context, but future studies are needed to replicate and further unravel the potentially stage-specific interplay between social context and PEs.

Keywords: clinical staging; diary study; loneliness; multilevel vector autoregression; psychosis.

Abstract

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