Positronium atoms (Ps) are widely used as a probe to characterize voids or vacancies in non-metallic materials. The annihilation lifetime of trapped Ps is strongly modified by pickoff, depending on the cavity size and on the appropriate external electron density. The connection between these material characteristics and Ps annihilation lifetimes is usually based on models that do not consider the requirements of full electron indistinguishability, that must be taken into account for a correct description of pickoff annihilation processes. In this report, we provide a formal theoretical framework in which exchange correlation effects between confined Ps and surrounding electrons are introduced in a natural way, giving a clear and versatile p...