Loneliness in severe mental illness: impact on relapse (360G-Wellcome-203618_Z_16_Z)

Loneliness is the distressing subjective feeling one’s social relationships do not meet one’s social needs. Its adverse impact in physical health and mortality is established. I will investigate its impact on relapse in acute psychiatric crises, and its potential mediating role between neighbourhood social deprivation and relapse. Objectives 1) Test hypothesis that loneliness is associated with: a. increased relapse rate at twelve months follow-up (primary hypothesis) b. reduced time to relapse c.increased service use and cost 2) Test if loneliness is associated with neighbourhood-level deprivation and social isolation Test if loneliness mediates any association between neighbourhood-level deprivation and relapse 3) Discovery replication: second acute psychiatric care cohort Methods Analyse data from multicentre cohort (UCL ‘CORE’) study of acute psychiatric patients with serious mental illness. Validate results in different cohort. I will use logistic regression, with adjustment for relevant confounders/modifiers, to test the hypotheses. I will use survival analysis, (Kaplan-Meier curves and Cox hazard ratios) for ‘time-to-relapse,’ and structural equation modeling to investigate whether loneliness mediates any relationship between deprivation and relapse. Key goals Establishing how loneliness affects outcomes should inform the development of future loneliness interventions. These may reduce relapse, and incorporate both individual and area-level elements.