Loneliness and risk of all-cause, Alzheimer's, vascular, and frontotemporal dementia: a prospective study of 492,322 individuals over 15 years.

OBJECTIVES: This study examined the association between loneliness and risk of incident all-cause dementia and whether the association extends to specific causes of dementia. DESIGN: Longitudinal. SETTING: Community. PARTICIPANTS: Participants were from the UK Biobank (N = 492,322). INTERVENTION: None. MEASUREMENTS: Loneliness was measured with a standard item. The diagnosis of dementia was derived from health and death records, which included all-cause dementia and the specific diagnoses of Alzheimer's disease (AD), vascular dementia (VD), and frontotemporal dementia (FTD), over 15 years of follow-up. RESULTS: Feeling lonely was associated with a nearly 60% increased risk of all-cause dementia (HR = 1.59, 95% CI = 1.51-1.65; n = 7,475 incident all-cause). In cause-specific analyses, loneliness was a stronger predictor of VD (HR = 1.82, 95% CI = 1.62-2.03; n = 1,691 incident VD) than AD (HR = 1.40, 95% CI = 1.28-1.53; n = 3135 incident AD) and was, surprisingly, a strong predictor of FTD (HR = 1.64, 95% CI = 1.22-2.20; n = 252 incident FTD). The associations were robust to sensitivity analyses and were attenuated but remained significant accounting for clinical (e.g. diabetes) and behavioral (e.g. physical activity) risk factors, depression, social isolation, and genetic risk. The association between loneliness and all-cause and AD risk was moderated by APOE ϵ4 risk status such that the increased risk was apparent in both groups but stronger among non-carriers than carriers of the risk allele. CONCLUSION: Loneliness is associated with increased risk of multiple types of dementia.

Going it alone: Examining interpersonal sensitivity and hostility as mediators of the link between perfectionism and social disconnection.

OBJECTIVE: Perfectionism is linked to a variety of mental health conditions in university students. The Perfectionism Social Disconnection Model posits that perfectionistic individuals exhibit off-putting interpersonal behaviors (i.e., rejection sensitivity and hostility), which lead to social disconnection, and in turn contribute to psychological distress. Although several longitudinal studies have found that social disconnection mediates the link between perfectionistic traits and psychological distress, less is known about how perfectionism leads to social disconnection. The present study aimed to address this gap. METHODS: A sample of 877 university students completed one survey a month for three consecutive months. RESULTS: Our random-intercept cross-lagged panel model results showed significant positive associations between the random intercepts of socially prescribed and self-oriented perfectionism with rejection sensitivity, hostility, and loneliness, with stronger associations for socially prescribed perfectionism. In addition, the random intercept of other-oriented perfectionism showed positive associations with hostility but not rejection sensitivity or loneliness. Moreover, almost all cross-lagged paths were nonsignificant. CONCLUSION: Collectively, these findings indicate that although perfectionistic traits may be associated with rejection sensitivity and hostility to varying degrees at the between-person level, these behaviors may not cause social disconnection at the within-person level.

Intimate Partner Violence Survivors' Daily Experiences of Social Disconnection, Substance Use, and Sex with Secondary Partners.

Women who have experienced intimate partner violence (IPV) are disproportionately likely to engage in sexual risk behavior, including sex with a secondary partner (i.e., sex partners outside their primary relationship). Social disconnection has been identified as a social determinant of health that may enhance understanding of sex with a secondary partner. This study extends past research by using an intensive longitudinal design consisting of multiple daily assessments to examine event-level associations between women IPV survivors' social disconnection and sex with a secondary partner concurrently (i.e., during the same aggregated assessment) and temporally (i.e., social disconnection during one assessment predicting sex with a secondary partner in a subsequent assessment) over a 14-day period, in consideration of physical, psychological, and sexual IPV, and alcohol and drug use. Participants (N = 244) were recruited from New England through 2017. Results from multilevel logistic regression models indicate that women who experienced greater social disconnection on average were more likely to report sex with a secondary partner. However, after including IPV and substance use in the model, the strength of this relationship was attenuated. Sexual IPV emerged as a between-person predictor of sex with a secondary partner in temporally lagged models. Results provide insight into the relationships between daily social disconnection and sex with a secondary partner among IPV survivors, particularly regarding the effects of substance use and IPV both concurrently and temporally. Taken together, findings emphasize the importance of social connection for women's well-being and highlight the need for interventions that enhance interpersonal connectedness.

Recruiting Socially Disconnected Latinos Caring for a Person with Alzheimer's Disease and Related Dementias During the COVID-19 Pandemic: Lessons Learned.

OBJECTIVES: The purpose of this article is to present conceptual and methodological challenges to recruitment strategies in enrolling socially disconnected middle-aged and older Latino caregivers of a loved one with Alzheimer's disease and related dementias (ADRD). METHODS: Middle-aged and older Latino ADRD caregivers were recruited into two early stage, intervention development studies during the COVID-19 pandemic via online or in-person methods. Recruitment criteria included Latino ADRD caregivers over the age of 40 reporting elevated loneliness on the UCLA 3-item Loneliness Scale (LS) during screening. RESULTS: Middle-aged, Latino caregivers were recruited predominantly from online methods whereas older caregivers were mostly recruited from in-person methods. We report challenges identifying socially disconnected Latino caregivers using the UCLA 3-item LS. CONCLUSIONS: Our findings support previously reported disparities in recruitment by age and language and suggest further methodological considerations to assess social disconnection among Latino caregivers. We discuss recommendations to overcome these challenges in future research. CLINICAL IMPLICATIONS: Socially disconnected Latino ADRD caregivers have an elevated risk for poor mental health outcomes. Successful recruitment of this population in clinical research will ensure the development of targeted and culturally sensitive interventions to improve the mental health and overall well-being of this marginalized group.

Resting (Tonic) Blood Pressure Is Associated With Sensitivity to Imagined and Acute Experiences of Social Pain: Evidence From Three Studies.

Social pain is a common experience that has potent implications for health. However, individuals differ in their sensitivity to social pain. Recent evidence suggests that sensitivity to social pain varies according to a biological factor that modulates sensitivity to physical pain: resting (tonic) blood pressure. The current studies extended this evidence by testing whether blood pressure relates to sensitivity to imagined (Study 1: N = 762, 51% female adults) and acute (Study 2, preregistered: N = 204, 57% female adults) experiences of social pain and whether associations extend to general emotional responding (Studies 1-3; Study 3: N = 162, 59% female adults). In line with prior evidence, results showed that higher resting blood pressure was associated with lower sensitivity to social pain. Moreover, associations regarding blood pressure and sensitivity to social pain did not appear to be explained by individual differences in general emotional responding. Findings appear to be compatible with the interpretation that social and physical pain share similar cardiovascular correlates and may be modulated by convergent interoceptive pathways.

Coping with the social challenges and emotional distress associated with hearing loss: a qualitative investigation using Leventhal's self-regulation theory.

OBJECTIVE: To explore the lived experience of social challenges and emotional distress in relation to hearing loss and the coping mechanisms employed to manage them. DESIGN: Two focus groups and two one-on-one semi-structured interviews were conducted during February 2020. Transcripts were first inductively analysed to identify experiential categories of social and emotional difficulty, and then deductively analysed using Leventhal's self-regulation model to identify how individuals conceptualised these experiences and the coping mechanisms employed to manage them. STUDY SAMPLE: Adults with hearing loss and self-reported emotional distress due to their hearing loss (n = 21) and their significant others (n = 9). RESULTS: Participants described their social and emotional experiences of hearing loss in terms of negative consequences (social overwhelm, fatigue, loss, exclusion), identity impact (how they perceive themselves and are perceived by others), and emotional distress (frustration, grief, anxiety, loneliness, and burdensomeness). While many participants described a general lack of effective coping strategies, others described employing coping strategies including avoidance (helpful and unhelpful), controlling the listening environment, humour, acceptance, assertiveness, communication repair strategies, and accepting support from significant others. CONCLUSION: Many participants described a lack of effective coping strategies and tended to rely on avoidance of social interaction,deepening their isolation and loneliness.

Multidomain Frailty as a Therapeutic Target in Elderly Patients with Heart Failure.

Heart failure and frailty share aging as a strong risk factor. The prevalence of frailty has been shown to be particularly high in elderly patients with heart failure. Moreover, it is important not to confine frailty to physical aspects. Rather, it should be considered to consist of multiple domains, including physical disability, psychiatric disorders, cognitive impairment, depression, and social disconnection. Development of interventions that can improve frailty domains are not well established, although observational studies have evaluated the association of various frailty domains and their prognostic impact. Some interventions, including resistance exercise, functional exercise, and respiratory muscle training have been demonstrated to hold potential for improving physical frailty. In terms of cognitive dysfunction, previous studies have demonstrated that exercise therapy is also effective for cognitive dysfunction. The social domain of frailty is one of the least investigated domains, particularly in patients with heart failure. However, heart failure is also strongly associated with physical frailty and cognitive impairment and has a poor prognosis in old patients. The prevalence of social frailty in elderly patients who need hospitalization due to heart failure is higher than previously thought. Very few studies have tested interventions targeting social frailty. Frailty and heart failure affect each other, and both are becoming increasingly important in society. In this article, we review the physical, cognitive, and social domains of frailty and the possible interventions to improve them in patients with heart failure.

[Suicidal behavior in light of COVID-19 outbreak: Clinical challenges and treatment perspectives]. / Épidémie de COVID-19 et prise en charge des conduites suicidaires : challenge et perspectives.

OBJECTIVE: The COVID-19 pandemic affected today more than 3,000,000 worldwide, and more than half of humanity has been placed in quarantine. The scientific community and the political authorities fear an epidemic of suicide secondary to this crisis. The aim of this review is to analyze the impact of the COVID-19 pandemic on the dimensions of the suicidal process and its interaction with the various risk factors. We also propose innovative strategies to manage suicidal behavior in the context of pandemic. METHODS: We carried out a narrative review of international publications dealing with major pandemics (COVID-19, SARS) and their influence on suicidal vulnerability. RESULTS: Many factors are likely to increase the emergence of suicidal ideation and suicide attempts during this crisis. Social distancing and quarantine could increase the feeling of disconnection and the perception of social pain in vulnerable individuals. Some populations at high suicidal risk could be further impacted by the current pandemic: the elderly, medical staff and individuals exposed to economic insecurity. Several innovative tools adapted to the constraints of social distancing and quarantine may prevent suicide risk: e-health, VigilanS, buddhist-derived practices and art engagement. CONCLUSIONS: This unprecedented crisis may interact with certain dimensions of the suicidal process. However, it is time to innovate. Several suicide prevention tools all have their place in new modes of care and should be tested on a large scale.

The Preteen Perfectionist: An Evaluation of the Perfectionism Social Disconnection Model.

This research investigated associations between socially prescribed and self-orientated perfectionism, and the social functioning of 510 preteens (Mage = 11.2). The study focused on predictions from the Perfectionism Social Disconnection Model (PSDM) by determining whether rejection sensitivity and social isolation, in that sequence, mediated the associations between both perfectionism types and mental health outcomes. Employing both survey and experimental methods, findings indicated that both types of perfectionism in preadolescence were associated with increased interpersonal difficulty, rejection sensitivity and feelings of social isolation, as well as higher levels of eating disorder symptoms, depression, and anxiety. Results from serial mediation analyses found general support for the theoretical predictions of the PSDM for socially prescribed perfectionism, and extending upon previous research, for self-orientated perfectionism. The age of the sample suggests that both forms of perfectionism may be important targets in programs to prevent the development of mental health problems.

Social Disconnection as a Pathway to Sexual Risk Behavior Among Victims of Intimate Partner Violence.

Intimate partner violence (IPV) victimization is a strong predictor of women's sexual risk behavior. Social disconnection may be central to understanding this association. In a sample of 204 IPV victims, we (a) evaluated the extent to which social disconnection underlies the association between IPV severity and sexual risk behavior, and (b) tested the idea that the association between social disconnection and sexual risk behavior is stronger among women without alternative means to social connection (i.e., lack close friendships). The indirect effect of physical and sexual IPV, respectively, on sexual risk behavior via social disconnection was significant. The number of close friends women had moderated the association between social disconnection and sexual risk behavior, such that having multiple close friendships buffered the effects of social disconnection.

Development of loneliness and social isolation after spousal loss: A systematic review of longitudinal studies on widowhood.

BACKGROUND: Spousal loss is a stressful life event that is associated with loneliness and social isolation, both of which affect mental and physical health. The primary objective of this paper was to synthesize longitudinal studies that investigated loneliness and social isolation in widowhood. METHODS: A systematic search of the literature was conducted using three electronic databases. 26 longitudinal studies published through June 2024 were included for further analysis. Participant characteristics, study design, and key findings were extracted. RESULTS: Most studies were from the United States or Europe, included more widows than widowers, and assessed loneliness in older adults aged >60 years. Loneliness peaked directly following spousal death, but findings were inconsistent regarding the lasting effects of widowhood. Heterogeneity in the longitudinal trajectories of loneliness was noted, with studies showing linear increases, decreases, or curvilinear relationships over time. Several factors modified the relationship between widowhood and loneliness, including volunteerism, military experience, income, and age. Widowers consistently reported greater loneliness and worse social isolation when compared with widows. Few studies investigated social isolation specifically, but those that did found that social isolation may decrease in widowhood. CONCLUSIONS: As the world grapples with a social pandemic of loneliness and social isolation, widowed adults may be uniquely affected. Few studies investigated the longitudinal trajectory of loneliness and especially social isolation in widowhood, and those that did found heterogenous results. Future work is needed to understand why some widowed adults are uniquely affected by feelings of loneliness and social isolation while others are not, and whether potentially modifiable factors that moderate or mediate this relationship could be leveraged by psychosocial interventions.

Application of an egocentric social network approach to examine changes in social connections following treatment for anxiety and depression: A novel measurement tool for clinical trials research?

The epidemic of loneliness and social isolation has been recognized as a public health crisis warranting the same prioritization as other public health issues today, such as obesity, substance use disorders, and tobacco use. Social disconnection is particularly prevalent and disabling among individuals with anxiety and depression, yet it is inadequately evaluated and addressed in most clinical psychology treatment research. Studies generally employ global measures of perceived connectedness, loneliness, or relationship satisfaction, limiting understanding about elements of one's social network that may change with treatment. This study examined changes in the degree (number of people nominated) and quality of one's social network from pre-to post-treatment using an egocentric social network approach in 59 adults (mean age = 30.8 years, range = 18 to 54) with clinically elevated anxiety or depression who were randomized to a cognitive and behavioral positive valence treatment versus waitlist. Participants (egos) named people in their lives (alters) with whom they discussed important issues or spent free time. For each alter, participants rated how close they felt, how close they thought the alter felt to them, and how frequently they communicated. Linear regressions, which included treatment group as a predictor, revealed no group differences in changes in network degree, perceived alter feelings of closeness, or communication frequency, despite prior findings from this sample indicating larger increases in perceived global connectedness in the treatment group. Unexpectedly, the control group reported a greater increase in perceived closeness to alters. Post-hoc analyses revealed this was explained by the treatment group identifying more distal social ties (e.g., extended family, colleagues, roommates) as alters following treatment - an outcome positively associated with global improvements in connectedness. This proof-of-concept study suggests egocentric social network surveys may provide unique information on treatment-related changes in social functioning. Suggestions are provided for adaptations to facilitate application of social network surveys to mental health treatment research.

Mental health impacts of COVID-19: A retrospective analysis of dynamic modelling projections for Australia.

Background: In early 2020, we developed a dynamic model to support policy responses aimed at mitigating the adverse mental health effects of the COVID-19 pandemic in Australia. As the pandemic has progressed, it has become clear that our initial model forecasts overestimated the impacts of infection control measures (lockdowns, physical distancing, etc.) on suicide, intentional self-harm hospitalisation, and mental health-related emergency department (ED) presentation rates. Methods: Potential explanations for the divergence of our model predictions from observed outcomes were assessed by comparing simulation results for a set of progressively more refined models with data on the prevalence of moderate to very high psychological distress and numbers of suicides, intentional self-harm hospitalisations, and mental health-related ED presentations published after our modelling was released in July 2020. Results: Allowing per capita rates of spontaneous recovery and intentional self-harm to differ between people experiencing moderate to very high psychological distress prior to the pandemic and those developing comparable levels of psychological distress only as a consequence of infection control measures substantially improves the fit of our model to empirical estimates of the prevalence of psychological distress and leads to significantly lower predicted effects of COVID-19 on suicide, intentional self-harm hospitalisation, and mental health-related ED presentation rates. Conclusion: Accommodating the influence of prior mental health on the psychological effects of population-wide social and economic disruption is likely to be critical for accurately forecasting the mental health impacts of future public health crises as they inevitably arise.

The Long Arm of Childhood Bullying Victimization: Associations with Social Isolation, Gender Differences and Depression in Later Life.

The association between childhood bullying victimization and depression has been well-explored among young adults, but little is known about whether this relationship persists into later life stages, specifically during middle-aged and older phases. Moreover, the intricate mechanisms underpinning this association and the potential existence of gender differences within this context remain inadequately elucidated. To address this gap in knowledge, this study aims to investigate the association between childhood bullying victimization and depression in later life, with a focus on exploring the mediating role of social isolation and the moderating roles of gender. A nationally representative sample of 5,070 individuals (mean age = 61.02, SD = 9.48; male = 55%) was drawn from the China Health and Retirement Longitudinal Study. By employing the bootstrapping analysis method, the mediating role of social isolation was examined, and the moderating role of gender was tested through the generation of interaction items. The results reveal a significant association between childhood bullying victimization and severe depression in later life. Additionally, social isolation plays a mediating role in this association between childhood bullying victimization and social isolation, and the association between social isolation and depression, as well as the relationship between social isolation and depression, are both moderated by gender, presenting stronger effects for female groups than for male groups. However, no moderating role of gender is found in terms of the direct association between childhood bullying victimization and depression. These findings highlight the fact that childhood bullying is not only a problem in the immediate term but also a concern that affects individuals across entire life course. This study has implications for healthcare in proactively investigating, diagnosing, and treating depression by inquiring about childhood bullying victimization experiences. Furthermore, intervention policies that aim to reduce social isolation may be particularly beneficial in mitigating the negative associations, especially for female individuals.

Social disconnection and suicide mortality among Japanese older adults: A seven-year follow-up study.

BACKGROUND: Few prospective studies have examined the association between social disconnection and late-life suicide. Therefore, we conducted a large-scale prospective study of older adults in Japan to examine differences in suicide mortality according to specific aspects of social disconnectedness. METHODS: We conducted a nationwide baseline survey of functionally independent older adults (age ≥65 years) from 12 municipalities in Japan from 2010 to 2011. We followed the participants (n = 46,144) for cause of death through December 2017 using vital statistics. Social disconnection was assessed based on the indicators of eating alone, a lack of instrumental/emotional support, no participation in community activities, and no contact with friends. We adopted Cox regression models with multiple imputation for missing values and calculated the population-attributable fraction (PAF). RESULTS: A total of 55 suicide deaths were recorded during an average follow-up of 7 years. Older adults with social disconnection had a marginally increased risk of suicide. The hazard ratio for eating alone vs. eating together was 2.81 (95% confidence interval [CI]: 1.47-5.37). The direction of these associations and point estimations did not largely change after controlling for depressive symptoms, an evident risk factor for suicidal behavior. The PAF indicated that eating alone was attributable to around 1800 (29%) of the suicide deaths among older adults annually in Japan. CONCLUSION: Avoidance of not only depressive symptoms, but also social disconnection including eating alone, is useful in suicide prevention among older adults.

Technology-Based Interventions to Address Social Isolation and Loneliness Among Informal Dementia Caregivers: A Scoping Review.

OBJECTIVE: Social isolation and loneliness are major public health concerns. Informal dementia caregivers are particularly vulnerable, as many are older adults themselves and at elevated risk of adverse mental and physical health outcomes. Technology-based interventions could offer accessible, affordable, and convenient solutions. A previous review included Internet-based supportive interventions for informal dementia caregivers published up to 2013; however, new publications, technological advances, and targeted outcomes justify conducting this scoping review. Here, we identified and synthesized recent technology-based interventions that addressed social isolation and loneliness among informal dementia caregivers. DESIGN: Scoping review. SETTING AND PARTICIPANTS: Informal dementia caregivers in the community. METHODS: Following Arksey and O'Malley's scoping review framework, we conducted a systematic search of peer-reviewed studies across 6 databases within the last 11 years, including identifying research questions, selecting relevant studies, charting data, and summarizing results. RESULTS: From the 2937 articles identified, 10 eligible studies were included in this review. The intervention type, format, and duration varied widely. Three categories of interventions to address social isolation and loneliness among informal dementia caregivers included technology-assisted peer support, newly developed Web-based multicomponent psychoeducational programs and platforms, and virtual adaptation and modification of existing programs. Predominantly qualitative evidence suggests that technology-based interventions have the potential to reduce feelings of loneliness and improve caregiver well-being. Quantitative evidence tends to be preliminary and inconclusive. CONCLUSIONS AND IMPLICATIONS: The findings offer preliminary evidence for technology-based interventions to reduce or prevent social isolation and loneliness in informal dementia caregivers. Technology-based interventions addressing social isolation and loneliness in informal dementia caregivers have the potential to overcome barriers to low uptake of services and withdrawal from interventions and improve the sustainability of the interventions. In the long run, by reducing or preventing social isolation and loneliness in informal dementia caregivers, the transition from home care to facility-based care might be delayed.

Schizophrenia in the mind, the brain and the body.

The author describes three lines of research programs that have guided her goal of elucidating the etiology of schizophrenia: working memory and representational guidance of behavior, disrupted social cognition and bodily-self disturbances.

A pilot choral intervention in individuals with schizophrenia-spectrum conditions; Singing away loneliness.

Social disconnection is associated with poor outcome and long-term disability in individuals with schizophrenia-spectrum conditions (SCZ) but social isolation is not typically a target for treatment. Singing together has long been shown to promote unique group cohesion and improve sense of well-being across the lifespan. Accordingly, we devised a novel choral intervention to examine the potential efficacy of this low-burden social intervention strategy designed to reduce loneliness in SCZ. Seventeen SCZ participated in a weekly, 1-hr choir group for 8 weeks. At pre- and post-intervention, we examined symptoms, loneliness, stress, and face recognition. Choral intervention led to significant reductions in scores for loneliness, the Brief Psychiatric Rating Scale (BPRS) and the Beck Depression Inventory-II (BDI-II). No significant changes were observed in scores for the Scale for the Assessment of Negative Symptoms (SANS), the Scale for the Assessment of Positive Symptoms (SAPS), face recognition, or the Perceived Stress Scale (PSS). Diminished loneliness was inversely correlated with the number of sessions attended. Participants judged the choir intervention to be acceptable and enjoyable. Reduced loneliness and symptom improvement after 8 weeks of intervention in SCZ suggest that choral intervention presents an enjoyable and low-burden opportunity to collaborate in a group setting for isolated individuals and thus may serve as a beneficial adjunct in a multi-arm intervention strategy for alleviating symptom distress and loneliness.

Should We Be Worried about Smartphone Addiction? An Examination of Canadian Adolescents' Feelings of Social Disconnection in the Time of COVID-19.

As the COVID-19 global pandemic limited face-to-face social contact, mental health concerns increased for adolescents. Additionally, many adolescents turned to technology to communicate with their peers, which also raised concerns about adolescent smartphone addiction. However, research has yet to examine how mental health and technology engagement are related to adolescents' feelings of social connection-an important developmental predictor of wellbeing across the lifespan. Specifically, little is known regarding the relative risk of adolescents' mental health concerns, a known risk factor for social disconnection and isolation and smartphone addiction in contributing to feelings of social disconnection in the time of COVID-19. The present study investigated how mental health outcomes and smartphone addiction contributed to Canadian adolescents' (n = 1753) feelings of social disconnection during COVID-19. Between October 2020 and May 2021, data were collected from five secondary schools in and around the lower mainland of British Columbia using an online-administered self-report questionnaire. Adolescents responded to questions about their smartphone addiction, internalizing problems, and an open-ended question about their feelings of connection to others. Findings from logistic regression analyses indicated that depression was a predictor of feeling socially disconnected: however, smartphone addiction was not associated with feelings of social disconnection during COVID-19. Implications of these findings can help inform the development of prevention programs targeting adolescents at risk for social disconnection in times of increased social isolation (e.g., a global pandemic). Specifically, these findings suggest that adolescents higher in depressive symptoms, and not those higher in smartphone addiction, are the ones most at risk.

Unrecognized schizophrenia spectrum and other mental disorders in youth disconnected from education and work-life.

Background: Schizophrenia spectrum disorders typically emerge during adolescence or early adulthood. Often the symptomatology is vague initially, while a marked functional decline and social withdrawal can be seen. A group of young people with such social and functional impairments is the so-called "Not in Education, Employment or Training" (NEET), i.e., a youth population that is socially disconnected from education and work-life. Despite the NEET group's disconnection from important parts of social life and a rising concern of an intersection with mental health problems, a psychopathological perspective on the problems experienced by this group remains underexplored. Aim: To examine a NEET sample for psychopathology and if relevant allocate psychiatric diagnoses. Methods: We performed an interview study comprising 40 participants from youth job-counseling services. All underwent a comprehensive psychiatric evaluation. Inclusion criteria were 18-29 years of age and a welfare benefit history of minimum 6 months. Results: Diagnostic criteria of any mental disorder were fulfilled by 95% of the sample; half of whom were diagnosed with a schizophrenia spectrum disorder. The participants with schizophrenia spectrum disorders had lower global functioning, were more often in contact with the mental health services and had higher PANSS and Examination of Anomalous Self-Experiences (EASE) scores compared to those with non-schizophrenia spectrum disorders. The participants fulfilling the criteria for schizophrenia spectrum disorders had lower EASE and PANSS scores than usually reported in the literature, suggesting more "symptom-poor" presentations. Conclusion: Psychiatric illness and particularly schizophrenia spectrum disorders affecting social interaction and the ability to take part in educational and work-life were grossly overrepresented in the NEET sample. Our findings suggest that pronounced social disconnection in youth in and of itself should lead to suspect the presence of a severe mental disorder.