Systematic review and conceptualisation of disaffection for its accompaniment.

Introduction: Disaffection is increasingly recognised as a psychological and relational process marked by the gradual loss of meaning in initially significant purposes, leading to relational deterioration and emotional distress. Although disaffection has been studied in fields such as education, political engagement, and healthcare, it remains poorly conceptualised as a distinct construct. Methods: This study addresses the definitional and disciplinary fragmentation surrounding disaffection by integrating a systematic review conducted in accordance with PRISMA 2020 guidelines with a theory-driven conceptual analysis. The review systematically identified and critically appraised empirical and theoretical uses of the term across three databases (Web of Science, Scopus, and PubMed) up to June 26, 2025, applying predefined inclusion and exclusion criteria regarding conceptual focus and study design, along with exclusion criteria related to methodological quality, assessed through Joanna Briggs Institute appraisal tools. The subsequent conceptual analysis, grounded in Erich Fromm's theoretical framework, delineates defining attributes, underlying psychological processes, and relational dimensions in order to provide an operational framework for research and accompaniment. To further ensure methodological rigour and minimise potential bias, additional safeguards were implemented throughout the review process. The two-stage screening procedure (titles/abstracts followed by full-text assessment) strengthened selection consistency, while the application of JBI critical appraisal tools ensured design-appropriate quality evaluation. Structured data extraction procedures enhanced transparency and reduced the risk of reporting distortions. Regarding the conceptual component, the adoption of Fromm's theoretical framework entails an interpretative positioning; this is explicitly acknowledged and theoretically justified to delimit the scope and implications of the analysis. Results: Sixty-seven studies were included, most from European contexts and covering political disaffection, disengagement in education, relational estrangement, and burnout in healthcare professions. Disaffection emerged as a multidimensional process with emotional (e.g., frustration, cynicism), behavioural (e.g., withdrawal, detachment, automatism), and cognitive (e.g., distrust, disidentification) components. The analysis highlights disaffection as distinct from related conditions such as depression, anxiety, or burnout, emphasising its specific relational and existential dimensions. Discussion: This review and conceptual analysis propose that disaffection is a progressive relational deterioration stemming from the perceived loss of meaning in commitments and interpersonal bonds, often leading to withdrawal into individualistic self-protection. The study provides an operationalisation of disaffection that may guide the development of instruments to detect early signs and inform preventive and reparative interventions. Limitations include reliance on Fromm's theoretical perspective and the absence of validated empirical measures. Further empirical research is needed to test the proposed conceptualisation and its applicability in clinical and educational contexts. In conclusion, this study conceptualises disaffection as a distinct relational-existential process and provides an operational framework to guide early detection and humanising accompaniment across clinical, educational and organisational contexts.