Loneliness and health in Eastern Europe: findings from Moscow, Russia

Association between single-person household wage workers in South Korea and insomnia symptoms: the 6th Korean Working Conditions Survey (KWCS)

BACKGROUND

The rise in single-person households is a global phenomenon with well-documented implications for both physical and mental well-being. However, there remains a scarcity of studies focusing specifically on the health impacts of single-person households on workers. This study aims to address this gap by comparing insomnia symptoms between single- and multi-person household workers, shedding light on the health implications of household composition.

METHODS

This study utilized data from the Sixth Korean Working Conditions Survey. Insomnia symptoms were categorized into normal sleep and insomnia symptom groups utilizing the 3-item Minimal Insomnia Symptom Scale. Multiple logistic regression analysis was employed to examine the association between single-person household wage workers and insomnia symptoms.

RESULTS

In comparison to wage workers from multi-person households, those from single-person households exhibited heightened risks of reporting insomnia symptoms. In the fully adjusted model, the odds ratios for symptoms of insomnia among single-person household wage workers was 1.173 (95% confidence interval: 1.020-1.349).

CONCLUSIONS

This study underscores that single-person household wage workers in Korea face an elevated risk of insomnia symptoms compared to their counterparts in multi-person households.

Divorce and physical health: A three-level meta-analysis

Divorce is often considered a major and stressful life transition. Given that divorcees are overrepresented in primary care and there is a association between individuals' physical health and psychological adjustment, potential post-divorce health problems are of concern. Yet, empirical evidence is lacking on the magnitude of the overall physical health risk after divorce, on possible differences across specific pathologies, and on factors that may increase or reduce this risk. The current meta-analysis addresses these issues. We identified 94 studies including u = 248 relevant effect sizes, based on N = 1,384,507 participants. Generally, compared to married individuals, divorcees showed significantly worse self-reported health (OR = 1.20, [1.08-1.33]), experienced more physical symptoms (OR = 1.34, [1.17-1.53]), and had a higher risk for diabetes (OR = 1.18 [1.05-1.33]), joint pathologies (OR = 1.24, [1.14-1.34]), cardiovascular (OR = 1.24, [1.09-1.41]) and cerebrovascular conditions (OR = 1.31, [1.14-1.51]), and sexually transmitted diseases (OR = 2.48, [1.32-4.64]). However, they had no increased risk of hypertension, hypercholesterolemia, cancer and cancer development, disabilities or limitations, or cognitive pathologies. Nor did divorcees significantly differ from married individuals when aggregating all pathologies to measure overall physical health problems (OR = 1.14, [0.85 to 1.54]). Yet, moderation analyses revealed that being female, unemployed, childless, or having a lower education constitutes a higher risk for overall physical health problems after divorce. The same applied to having a heavy alcohol consumption, lack of exercise, and being overweight. Our meta-analysis shows that divorcees are at heightened risk of certain pathologies, with sexually transmitted diseases as a particular post-divorce hazard. These findings call for more awareness among counsellors and physicians on divorcees' health conditions and the characteristics that make divorcees even more vulnerable to health problems.

Loneliness prevalence of community-dwelling older adults and the impact of the mode of measurement, data collection, and country: A systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review and meta-analysis is to assess the prevalence of loneliness in many countries worldwide which have different ways of assessing it.

DESIGN

Systematic review and meta-analysis.

SETTING

We searched seven electronic databases for English peer-reviewed studies published between 1992 and 2021.

PARTICIPANTS

We selected English-language peer-reviewed articles, with data from non-clinical populations of community-dwelling older adults (>60 years), and with "loneliness" or "lonely" in the title.

MEASUREMENTS

A multilevel random-effects meta-analysis was used to estimate the prevalence of loneliness across studies and to pool prevalence rates for different measurement instruments, data collection methods, and countries.

RESULTS

Our initial search identified 2,021 studies of which 45 (k = 101 prevalence rates) were included in the final meta-analysis. The estimated pooled prevalence rate was 31.6% (n = 168,473). Measurement instrument was a statistically significant moderator of the overall prevalence of loneliness. Loneliness prevalence was lowest for single-item questions and highest for the 20-item University of California-Los Angeles Loneliness Scale. Also, differences between modes of data collection were significant: the loneliness prevalence was significantly the highest for face-to-face data collection and the lowest for telephone and CATI data collection. Our moderator analysis to look at the country effect indicated that four of the six dimensions of Hofstede also caused a significant increase (Power Distance Index, Uncertainty Avoidance Index, Indulgence) or decrease (Individualism) in loneliness prevalence.

CONCLUSIONS

This study suggests that there is high variability in loneliness prevalence rates among community-dwelling older adults, influenced by measurement instrument used, mode of data collection, and country.

Exploring the role of country-level gender equality in the link between relationship status and perceived social support across 49 countries

Past studies have demonstrated that higher perceived social support among coupled individuals and greater gender equality foster a more supportive social context. Less is known about how the link between relationship status and perceived social support may vary across countries that differ in gender equality. Employing the data collected from the COVIDiSTRESS I (39 countries; N = 99,075) and COVIDiSTRESS II (23 countries; N = 8293) projects, we examined whether country-level gender equality moderates the link between relationship status and perceived social support. Multilevel regression analyses indicated that gender equality moderated the link between relationship status and perceived social support. Single people in countries with less gender equality reported less perceived social support than was reported by both coupled people and single people from countries with moderate and high levels of gender equality, however, the effect of the interaction between relationship status and gender equality on perceived social support was very low. The results suggest that gender equality fosters perceived social support, both for single people and for partnered people.

Longitudinal associations of loneliness with mental ill-health, physical ill-health, lifestyle factors and mortality in ageing adults in Thailand

OBJECTIVES

The aim of this study was to assess the longitudinal association between loneliness, mental and physical ill-health indicators, lifestyle factors and mortality among middle-aged and older adults in Thailand.

METHODS

We analyzed prospective cohort data of participants 45 years and older from three consecutive waves in 2015 (n = 5616), 2017 (n = 3600), and in 2020 (n = 2863) of the Health, Aging and Retirement in Thailand (HART) study. Loneliness was assessed with a single item. To assess the longitudinal associations between loneliness and health outcomes between 2015 (baseline), 2017 (first follow-up) and 2020 (second follow-up), we conducted Generalized Estimating Equations analysis (GEE).

RESULTS

The proportion of loneliness was 21.6% in 2015, 23.8% in 2017 and 21.3% in 2020. In the adjusted GEE logistic regression model, loneliness was positively associated with mental ill-health (poor self-rated mental health status, poor quality of life/happiness, depressive symptoms, and insomnia symptoms), physical ill-health (poor self-rated physical health status, hypertension, kidney disease, osteoporosis, and ADL disability), and lifestyle factors (physical inactivity, and having underweight). Furthermore, in adjusted Cox proportional hazards regression, loneliness was associated with mortality. In adjusted logistic regression, compared to without loneliness in all three study waves, having loneliness in one wave and/or two to three waves was positively associated with incident mental ill-health (incident poor self-rated mental health status, incident poor quality of life/happiness, incident depressive symptoms, and incident insomnia symptoms), incident physical ill-health (incident poor self-rated physical health status, incident diabetes, incident kidney disease, and incident ADL disability), and incident lifestyle factors (having incident underweight).

CONCLUSION

We found that loneliness was associated with several mental and physical ill-health indicators, lifestyle factors and mortality. Enhanced screening and treatment of loneliness may reduce mental and physical ill-health indicators in Thailand.

Relationship between alexithymia, loneliness, resilience and non-suicidal self-injury in adolescents with depression: a multi-center study

OBJECTIVE

Non-suicidal self-injury (NSSI) behaviors are prevalent in adolescents and have adverse effects on physical and mental health. However, little is known about the relationship between NSSI and alexithymia, or the underlying mechanisms that could explain this relationship. This study aimed to elucidate the current status of NSSI in adolescent depression, and analyze the relationship between alexithymia, loneliness, resilience, and adolescent depression with NSSI, so as to provide a theoretical basis for psychotherapeutic interventions.

METHOD

The study sample involved inpatients and outpatients from 12 hospitals across China and adolescents with depression who met the DSM-5 diagnostic criteria for depression episode. The following scales were used: The Functional Assessment of Self-Mutilation, Toronto Alexithymia Scale, UCLA Loneliness Scale, and Connor Davidson Resilience Scale.

RESULTS

The detection rate of NSSI in adolescents with depression from 2021.01.01-2022.01.01 was 76.06% (1782/2343). Spearman's correlation analysis revealed a significant correlation between alexithymia, loneliness, resilience and NSSI in depressed adolescents, and the results of the non-parametric test showed that the differences between the two groups for each factor were statistically significant. Binary logistic regression results showed that alexithymia (B = 0.023, p = 0.003, OR = 1.023, 95% CI: 1.008-1.038) and depression (B = 0.045, p < 0.001, OR = 1.046, 95% CI: 1.026-1.066) are risk factors for NSSI, resilience (B = - 0.052, p < 0.001, OR = 0.949, 95% CI: 0.935 - 0.964) is a protective factor for NSSI. Alexithymia directly predicted NSSI and also indirectly influenced NSSI through the mediated effect of resilience. Loneliness moderates the first half of the path of this mediated model.

CONCLUSION

The present study confirms a moderated mediation effect: Alexithymia can have an impact on NSSI behaviors in depressed adolescents through the mediating role of resilience. Loneliness, as a moderating variable, moderated the first half of the pathway of the mediating model. We discuss perspectives for future research and interventions based on the findings of the study.

Prevalence and associated factors of incident and persistent loneliness among middle-aged and older adults in Thailand

BACKGROUND

The aim of the study was to assess the prevalence and associated factors of incident and persistent loneliness in a prospective cohort study among middle-aged and older adults (≥ 45 years) in Thailand.

METHODS

Longitudinal data from the Health, Aging, and Retirement in Thailand (HART) study in 2015 and 2017 were analysed. Loneliness was assessed with one item from the Center for Epidemiological Studies Depression scale. Logistic regression was used to calculate predictors of incident and persistent loneliness.

RESULTS

In total, at baseline 21.7% had loneliness, 633 of 3696 participants without loneliness in 2015 had incident loneliness in 2017 (22.2%), and 239 of 790 adults had persistent loneliness (in both 2015 and 2017) (30.3%). In adjusted logistic regression analysis, low income (aOR: 1.27, 95% CI: 1.03 to 1.57), poor self-rated physical health status (aOR: 1.64, 95% CI: 1.27 to 2.12), hypertension (aOR: 1.34, 95% CI: 1.09 to 1.65), depressive symptoms (aOR: 1.97, 95% CI: 1.11 to 3.49), and having three or chronic conditions (aOR: 1.76, 95% CI: 1.19 to 2.60) were positively associated and a higher education (aOR: 0.74, 95% CI: 0.55 to 0.98) and living in the southern region of Thailand (aOR: 0.43, 95% CI: 0.30 to 0.61) were inversely associated with incident loneliness. Poor self-rated physical health status (aOR: 1.91, 95% CI: 1.26 to 2.88), and having three or more chronic diseases (aOR: 1.78, 95% CI: 1.07 to 2.98), were positively associated, and living in the southern region (aOR: 0.40, 95% CI: 0.25 to 0.65) was inversely associated with persistent loneliness.

CONCLUSION

More than one in five ageing adults had incident loneliness in 2 years of follow-up. The prevalence of incident and/or persistent loneliness was higher in people with a lower socioeconomic status, residing in the central region, poor self-rated physical health status, depressive symptoms, hypertension, and a higher number of chronic diseases.

Self-esteem mediated relations between loneliness and social anxiety in Chinese adolescents with left-behind experience

Although research examining loneliness and social anxiety has been conducted, few studies have explored pathways from loneliness at home to social anxiety at school in Chinese left-behind children. The study attempts to explore associations between loneliness at home and social anxiety at school and to examine roles of self-esteem in those relationships among a sample of Chinese left-behind children. Date were collected from 303 left-behind children, aged 10-14 years, and the Chinese versions of Children's Loneliness Scale, Social Anxiety Scale, and Rosenberg Self-esteem Scale were used to measure loneliness at home, social anxiety at school, and self-esteem, respectively. Results showed that loneliness at home was positively associated with social anxiety at school; self-esteem played a partial mediation role in associations between loneliness at home and social anxiety at school. Findings suggest that high levels of self-esteem may influence pathways from loneliness at home to social anxiety at school in Chinese left-behind children, and increasing levels of self-esteem may be used in preventions for loneliness of Chinese left-behind children.

Associations of loneliness with poor physical health, poor mental health and health risk behaviours among a nationally representative community-dwelling sample of middle-aged and older adults in India

OBJECTIVES

Loneliness may negatively impact on health outcomes. The study aimed to estimate the associations between loneliness and poor physical health, poor mental health, and health risk behaviours in middle-aged and older adults in a national population survey in India.

METHODS

The sample included 72,262 middle-aged and older adults from a cross-sectional national community-dwelling survey in India in 2017-2018.

RESULTS

Results indicate that the prevalence of moderate loneliness was 20.5%, and severe loneliness was 13.3%. In the adjusted logistic regression analysis, moderate and/or severe loneliness was significantly positively associated with fair or poor self-rated health status, and significantly negatively associated with life satisfaction and cognitive functioning. Furthermore, loneliness was associated with stroke, angina, physical injury, difficulty of Activities of Daily Living, difficulties of Instrumental Activities of Daily Living and multi-morbidity. Loneliness increased the odds of major depressive disorder and insomnia symptoms. The associations between loneliness and current tobacco use and body mass index were negative and between loneliness and physical inactivity and underweight were positive.

CONCLUSIONS

Loneliness is associated with poor physical health, poor mental health and health risk behaviour (physical inactivity), emphasising the need to consider loneliness in various physical and mental health contexts.

How Compassionate Abilities Influence the Experience of Loneliness and Quality of Life of People with and without Chronic Physical Disease?

The current study aimed to test whether individuals with and without a chronic physical disease differ in levels of compassionate abilities, loneliness and quality of life (QoL); and to examine whether loneliness mediated the impact of self-compassion and of receiving compassion from others in physical, psychological, and social QoL. In this cross-sectional study, individuals with (n = 278) and without (n = 455) physical chronic disease were recruited through an online self-report protocol. The Compassionate Attributes and Engagement Scale, the UCLA Loneliness Scale, and the World Health Organization's QoL-BREF were used. Individuals with a chronic physical disease diagnosis reported lower compassionate abilities and QoL, as well as higher levels of loneliness, when compared to participants without a diagnosis. For both samples, compassionate abilities were negatively linked to loneliness, and positively linked to QoL. Path analysis results indicated that compassionate abilities have a direct effect on loneliness, which explains individuals' perceived QoL. Results highlight the crucial role of self-compassion skills and the ability to perceive others as compassionate, in loneliness and QoL, both in individuals with and without a chronic physical disease. These findings seem to have important research and clinical implications.

Feelings of loneliness and mental health needs and services utilization among Chinese residents during the COVID-19 epidemic

BACKGROUND

Due to the implementation of social distancing and quarantine measures, loneliness has been a major public health concern during the COVID-19 pandemic. However, few studies have examined loneliness in Chinese residents during the COVID-19 epidemic, as well as its associations with mental health needs and services utilization.

METHODS

The present study was a cross-sectional survey during the COVID-19 outbreak in China. A total of 7741 adults were invited and completed an online self-administered questionnaire. The Chinese 12-item General Health Questionnaire was used to screen for common mental health problems, loneliness was measured with a single-item self-report question ("How often do you feel lonely in recent days?"), and two standardized questions were used to assess perceived needs for and use of mental health services.

RESULTS

In total, 24.2 % of the participants felt lonely in recent days. Age of 16-29 years (OR = 1.36, P = 0.020), marital status of never-married (OR = 1.47, P < 0.001), marital status of "others" (re-married, co-habiting, separated, divorced, and widowed) (OR = 1.72, P < 0.001), having infected family members or close relatives (OR = 1.64, P = 0.026), and having infected colleagues, friends, or classmates (OR = 1.62, P < 0.001) were significant correlates of loneliness. Rates of mental health needs (17.4 % vs. 4.9 %, P < 0.001) and services utilization (2.7 % vs. 1.0 %, P < 0.001) were significantly higher in lonely than not lonely participants. After adjusting for socio-demographic and epidemic characteristics and common mental health problems, loneliness was still significantly associated with mental health needs (OR = 2.50, P < 0.001) and services utilization (OR = 1.62, P = 0.020).

CONCLUSIONS

Feelings of loneliness are prevalent among Chinese residents affected by the COVID-19 epidemic and the presence of loneliness is associated with high levels of mental health needs and greater services utilization. Effective measures aiming at preventing or reducing loneliness are potentially beneficial for the mental wellbeing of COVID-19-affected population and reducing the use of the limited mental health service resources during the COVID-19 pandemic.

Loneliness is associated with poor mental health, social-environmental factors, and health risk behaviours among national samples of in-school adolescents in four Caribbean countries

The goal of the study was to estimate associations of loneliness with poor mental health, social-environmental and health risk behaviour indicators among adolescents in the Caribbean. Cross-sectional national 'Global School-Based Student Health Survey (GSHS)' data of four Caribbean countries (N = 9,143 adolescents) in 2016-2017 were analysed. In adjusted logistic regression analysis, loneliness was significantly positively associated with all five poor mental health outcomes (having no close friends, anxiety-induced sleep disturbance, suicidal ideation, suicide plan and suicide attempt). Regarding social-environmental outcomes, loneliness was significantly positively associated with bullying victimization, having been physically attacked, involvement in fighting, frequent experiences of hunger and passive smoking (in particular among boys). In terms of health risk behaviour outcomes, loneliness significantly increased the odds for current tobacco use, ever drunk, trouble from alcohol use, ever amphetamine use, multiple sexual partners, leisure-time sedentary behaviour, injury and frequent soft drink consumption. In addition, among boys, loneliness increased the likelihood for current cannabis use. Loneliness is associated with poorer mental health, social-environmental risk factors and health risk behaviours. Results show the importance of taking loneliness into account in a number of mental, social, and physical health factors.

Typologies of Loneliness, Isolation and Living Alone Are Associated with Psychological Well-Being among Older Adults in Taipei: A Cross-Sectional Study

BACKGROUND

Loneliness, isolation, and living alone are emerging as critical issues in older people's health and well-being, but the effects are not consistent. The purpose of this study was to examine the clustering of loneliness, isolation, and living alone, the risk factors and the associations with psychological well-being.

METHODS

The data were collected from the 2019 Taipei City Senior Citizen Condition Survey by face-to-face interviews and included a community-based sample (n = 3553). Loneliness, isolation, and living arrangement were analyzed by cluster analysis to define Loneliness-Isolation-Living-Alone clusters. Multinomial logistic regression was used to examine the factors related to Loneliness-Isolation-Living-Alone clusters, and linear regression was used to examine association of clusters with psychological well-being.

RESULTS

Five clusters of older adults were identified and named as follows: Not Lonely-Connected-Others (53.4%), Not Lonely-Isolated-Others (26.6%), Not Lonely-Alone (5.0%), Lonely-Connected (8.1%), and Lonely-Isolated-Others (6.9%). Demographics, financial satisfaction, physical function, family relationship, and social participation were related to the Loneliness-Isolation-Living-Alone clusters. Compared with the Not Lonely-Connected-Others cluster, the Lonely-Connected cluster and Lonely-Isolated-Others cluster had higher depressive symptoms and lower life satisfaction, and the Not Lonely-Isolated-Others cluster reported lower life satisfaction; the Not Lonely-Alone cluster was not different.

DISCUSSION

Loneliness and isolation are negatively associated with psychological well-being, and living arrangement is not the determinant to loneliness or isolation. Older adults are suggested to strengthen their informal social support, and the government may encourage social care and create an age friendly environment to reduce loneliness and isolation.

Reciprocal Effects Between Loneliness and Sleep Disturbance in Older Americans

Objectives: To model the relationship between loneliness and sleep disturbance over time. Method: Data came from the Health and Retirement Study (2006, 2010, 2014 waves; age ≥ 65 years; n = 5,067). Loneliness was measured via the Hughes Loneliness Scale and sleep disturbance via a four-item scale assessing sleep and restedness. Cross-lagged panel modeling (path analysis) was used to jointly examine reciprocal effects between loneliness and sleep disturbance. Results: Higher loneliness correlated with higher sleep disturbance at baseline. There was evidence of reciprocal effects between loneliness and sleep across timepoints. These associations overall remained when accounting for demographics, objective isolation, and depression. Discussion: Although causality cannot be established, the findings indicate that the relationship between loneliness and sleep disturbance is bidirectional. This requires revision to the current theory on sleep disturbance as a mechanism for the relationship between loneliness and health and indicates that effective treatment of sleep disturbance may reduce loneliness.

Loneliness correlates and associations with health variables in the general population in Indonesia

Background

Loneliness has been commonly reported in high-income countries, while less is known about loneliness in Association of the Southeast Asian Nations (ASEAN) member states, in particular in Indonesia.

Objective

The aim of the study was to estimate the prevalence of loneliness, its correlates and associations with health variables in a national survey in the general population in Indonesia.

Methods

In the Indonesia Family Life Survey (IFLS-5) in 2014–2015, 31,447 participants 15 years and older (median age 35.0 years, interquartile range = 22.0) were interviewed and examined in a national population-based cross-sectional study. The self-reported prevalence of loneliness, blood pressure, body height and weight, physical and mental health, health behaviour and psychosocial variables were measured. Multinomial logistic regression analyses were used to estimate determinants of loneliness and logistic and linear regression analyses were applied to estimate the associations of loneliness with physical, mental and health risk behaviour variables.

Results

The self-reported prevalence of loneliness (occasionally or all of the time or 3–7 days per week) was 10.6% (11.0% for females and 10.1% for males), and 8.0% reported sometimes (1–2 days/week) to be lonely. Loneliness was distributed in a slight U-shaped form, with adolescents and the oldest old having the highest prevalence of loneliness. In adjusted multinomial logistic regression analysis, lower education, lower economic status, adverse childhood experiences, having one or more chronic conditions, functional disability and low neighbourhood trust were associated with loneliness. Loneliness was significantly associated with most health variables, including self-reported unhealthy health status (AOR 1.70, CI 1.57, 1.84), cognitive functioning (Beta: − 0.72, CI − 0.90 to − 0.54), having one or more chronic medical conditions (AOR 1.25, CI 1.16, 1.35), having had a stroke (AOR 1.58, CI 1.08, 2.29), depression symptoms (Beta: 5.19, CI 4.98–5.39), sleep disturbance (Beta: 0.34, CI 0.31–0.37), sleep related impairment (Beta: 0.69, CI 0.64–0.73), low life satisfaction (AOR 1.78, CI 1.64, 1.93), out-patient health care utilization in the past 4 weeks (AOR 1.11, CI 1.01, 1.21), current tobacco use (AOR 1.42, CI 1.28, 1.58), and one or more days in the past week soft drink consumption (AOR 1.20, CI 1.10, 1.31).

Conclusion

Loneliness was found to be prevalent across the life span and was associated with a number of poorer health variables. Several factors associated with loneliness were identified, which warrant further research in Indonesia.

'Loneliness in the city': examining socio-economics, loneliness and poor health in the North East of England

OBJECTIVES

The aim of this study was to discover whether lower socio-economic status is associated with increased experiences of loneliness and isolation. The research subsequently determined whether this relationship impacted health inequalities.

STUDY DESIGN

The study used a cross-sectional, self-reported survey collecting information on loneliness, isolation and poor health (n = 680). The survey was administered through Sunderland District Council in 2016-2017, and data were analysed at The University of Sunderland.

METHODS

The study used a quantitative approach, and data were analysed using descriptive statistics, engaging in univariate, bivariate and multivariate levels of analysis.

RESULTS

A number of significant findings emerged from the data analysis, linking lower socio-economic status to experiences of loneliness (P = 0.000) and social isolation (P = 0.000). When determining if social isolation and socio-economics had a detrimental impact on a person's health, no statistical association was discovered (P = 0.098). Yet, there was a significant relationship concerning socio-economic status, loneliness and poor health (P = 0.026).

CONCLUSIONS

The authors have identified a number of associations within the data with reference to isolation, loneliness and poor health. Therefore, participants from a lower socio-economic group experienced disproportionately high levels of social isolation and emotional loneliness when compared with other socio-economic groups. The data also demonstrate that participants who experienced loneliness, and who were from a lower socio-economic background, were consistently more likely to report poor health than those from other socio-economic backgrounds.

The effect of loneliness on depression: A meta-analysis

BACKGROUND

Negative emotions, which have a common, chronic and recurrent structure, play a vital role in the development and maintenance of psychopathology. In this study, loneliness as a negative emotion was considered to be a predisposing factor in depression.

AIM

The aim of this meta-analysis is to determine the effect of loneliness on depression.

METHOD

Initially, a literature scan was performed and all related literature was pooled together ( n = 531). Based on scales determined by the researchers, it was decided to include 88 studies in the analysis. This study obtained a sampling group of 40,068 individuals.

RESULTS

The results of using a random effects model for analysis showed that loneliness had a moderately significant effect on depression. None of the variables of study sampling group, type of publication and publication year were found to be moderator variables.

CONCLUSION

According to the results of the research, loneliness may be said to be a significant variable affecting depression. The findings obtained are discussed in light of the literature.

Feasibility of Virtual Tablet-Based Group Exercise Among Older Adults in Siberia: Findings From Two Pilot Trials

Background

Regular physical activity has a positive effect on physical health, well-being, and life satisfaction of older adults. However, engaging in regular physical activity can be challenging for the elderly population because of reduced mobility, low motivation, or lack of the proper infrastructures in their communities.

Objective

The objective of this paper was to study the feasibility of home-based online group training—under different group cohesion settings—and its effects on adherence and well-being among Russian older adults. We focused particularly on the technology usability and usage and on the adherence to the training (in light of premeasures of social support, enjoyment of physical activity, and leg muscle strength). As a secondary objective, we also explored the effects of the technology-supported intervention on subjective well-being and loneliness.

Methods

Two pilot trials were carried out exploring two different group cohesion settings (weak cohesion and strong cohesion) in the period from 2015 to 2016 in Tomsk, Russian Federation. A total of 44 older adults (59-83 years) participated in the two pilots and followed a strength and balance training program (Otago) for 8 weeks with the help of a tablet-based virtual gym app. Participants in each pilot were assigned to an interaction condition, representing the online group exercising, and an individual condition, representing a home-based individual training. Both conditions featured persuasion strategies but differed in the ability to socialize and train together.

Results

Both interaction and individual groups reported a high usability of the technology. Trainees showed a high level of technology acceptance and, particularly, a high score in intention to future use (4.2-5.0 on a 5-point Likert scale). Private texting (short service message [SMS]) was used more than public texting, and the strong cohesion condition resulted in more messages per user. Joint participations to training sessions (copresence) were higher for the social group with higher cohesion. The overall adherence to the training was 74% (SD 27%). Higher levels of social support at baseline were associated with higher adherence in the low cohesion condition (F1,18=5.23, P=.03), whereas in the high cohesion, such association was not found. Overall improvement in the satisfaction with life score was observed between pre and post measures (F1,31=5.85, P=.02), but no decrease in loneliness.

Conclusions

Online group exercising was proven feasible among healthy independently living older adults in Russia. The pilots suggest that a physical training performed in a virtual environment positively affect the life satisfaction of the trainees, but it does not provide support for a decrease in loneliness. High cohesion groups are preferable for group exercising, especially to mitigate effects of low social support on adherence. Further research in motivating group interactions in training settings is needed.

Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey

Introduction

Loneliness is a common, emotionally distressing experience and is associated with adverse physical and mental health and an unhealthy lifestyle. Nevertheless, little is known about the prevalence of loneliness in different age groups in Switzerland. Furthermore, the existing evidence about age and gender as potential effect modifiers of the associations between loneliness, physical and mental health and lifestyle characteristics warrants further investigation. Thus, the aim of the study was to examine the prevalence of loneliness among adults in Switzerland and to assess the associations of loneliness with several physical and mental health and behavioral factors, as well as to assess the modifying effect of sex and age.

Methods

Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 (SHS) were analyzed. Logistic regression analyses were used to assess associations of loneliness with physical and mental health or lifestyle characteristics (e.g. diabetes, depression, physical activity). Wald tests were used to test for interactions.

Results

Loneliness was distributed in a slight U-shaped form from 15 to 75+ year olds, with 64.1% of participants who had never felt lonely. Lonely individuals were more often affected by physical and mental health problems, such as self-reported chronic diseases (Odds ratio [OR] 1.41, 95% confidence interval [CI] 1.30–1.54), high cholesterol levels (OR 1.31, 95% CI 1.18–1.45), diabetes (OR 1.40, 95% CI 1.16–1.67), moderate and high psychological distress (OR 3.74, 95% CI 3.37–4.16), depression (OR 2.78, 95% CI 2.22–3.48) and impaired self-perceived health (OR 1.94, 95% CI 1.74–2.16). Loneliness was significantly associated with most lifestyle factors (e.g. smoking; OR 1.13, 95% 1.05–1.23). Age, but not sex, moderated loneliness’ association with several variables.

Conclusion

Loneliness is associated with poorer physical and mental health and unhealthy lifestyle, modified by age, but not by sex. Our findings illustrate the importance of considering loneliness for physical and mental health and lifestyle factors, not only in older and younger, but also in middle-aged adults. Longitudinal studies are needed in Switzerland to elucidate the causal relationships of these associations.

Birthdays are associated with an increased risk of suicide in Japan: Evidence from 27,007 deaths in Tokyo in 2001-2010

BACKGROUND

Previous research has produced conflicting findings concerning whether birthdays are associated with an increased risk of suicide. This study examined the association in Tokyo, Japan.

METHODS

Suicide data (ICD-10 codes X60-X84) for the period 2001-2010 were obtained from the Japanese Ministry of Health, Labour and Welfare. A time-stratified case-crossover design was used with conditional logistic regression analysis being performed to estimate within-subject 'birthday exposures' while controlling for meteorological conditions and public holidays.

RESULTS

There were 27,007 suicides in the study period. For males the 5 days before the birthday and the week after the birthday were associated with significantly higher odds for suicide with the odds ratio being highest on the actual birthday (OR =1.677, 95% CI: 1.294, 2.172). For females, significantly higher odds for completed suicide were observed 7-11 days before the birthday. Stratified analyses showed different at risk time patterns among men from different age groups, and that married men had higher odds for suicide on, and for the 4 days before and in the 2 weeks after their birthday.

LIMITATIONS

We lacked detailed information on suicides which would have enabled a better understanding of the observed associations.

CONCLUSIONS

Birthdays are associated with an increased risk for suicide in Tokyo, Japan. Health professionals who work with individuals at risk of suicide should be made aware that birthdays are associated with an elevated suicide risk. This information should also be communicated in wider suicide prevention campaigns.

Social capital - a mixed blessing for women? A cross-sectional study of different forms of social relations and self-rated depression in Moscow

BACKGROUND

Depression is a major health problem worldwide, especially among women. The condition has been related to a number of factors, such as alcohol consumption, economic situation and, more recently, to social capital. However, there have been relatively few studies about the social capital-depression relationship in Eastern Europe. This paper aims to fill this gap by examining the association between different forms of social capital and self-rated depression in Moscow. Differences between men and women will also be examined, with a special focus on women.

METHODS

Data was obtained from the Moscow Health Survey, which was conducted in 2004 with 1190 Muscovites aged 18 years or above. For depression, a single-item self-reported measure was used. Social capital was operationalised through five questions about different forms of social relations. Logistic regression analysis was undertaken to estimate the association between social capital and self-rated depression, separately for men and women.

RESULTS

More women (48 %) than men (36 %) reported that they had felt depressed during the last year. An association was found between social capital and reported depression only among women. Women who were divorced or widowed or who had little contact with relatives had higher odds of reporting depression than those with more family contact. Women who regularly engaged with people from different age groups outside of their families were also more likely to report depression than those with less regular contact.

CONCLUSIONS

Social capital can be a mixed blessing for women. Different forms of social relations can lead to different health outcomes, both positive and negative. Although the family is important for women's mental health in Moscow, extra-familial relations across age groups can be mentally distressing. This suggests that even though social capital can be a valuable resource for mental health, some of its forms can be mentally deleterious to maintain, especially for women. More research is needed on both sides to social capital. A special focus should be placed on bridging social relations among women in order to better understand the complex association between social capital and depression in Russia and elsewhere.

Voluntary and Involuntary Singlehood and Young Adults' Mental Health: an Investigation of Mediating Role of Romantic Loneliness

The present study tested the hypothesis that single young adults who perceive their singlehood as voluntary would report a higher level of positive mental health (i.e., emotional, psychological and social well-being), lower levels of mental health illness (i.e., somatic symptoms, anxiety, social dysfunction, severe depression) and romantic loneliness in comparison to young adults who perceive their singlehood as involuntary. This paper also investigated whether romantic loneliness mediates the relationship between voluntary and involuntary singlehood, positive mental health, and mental health illness. The study sample included 151 participants (86 females and 65 males) aged 20–26 (M = 22.48, SD = 2.01) from Poland. The main findings were that voluntarily single young adults reported a lower level of romantic loneliness compared to involuntarily single young adults. The two groups differed neither in regard to positive mental health nor in regard to mental health problems. In addition, gender differences were observed solely in the domain of romantic loneliness, with women reporting greater romantic loneliness than men. The mediation analysis revealed that romantic loneliness does not mediate the relationship between voluntary and involuntary singlehood, positive mental health, and mental health illness. Voluntary and involuntary singlehood was predictive of somatic symptoms, anxiety and insomnia, severe depression, and romantic loneliness.

Loneliness, common mental disorders and suicidal behavior: Findings from a general population survey

BACKGROUND

Loneliness has been linked to an increased risk of engaging in suicidal behavior. To date, however, there has been comparatively little research on this in the general adult population, or on the role of common mental disorders (CMDs) in this association. The current study examined these associations using nationally representative data from England.

METHODS

Data came from the Adult Psychiatric Morbidity Survey 2007. Information was obtained from 7403 household residents aged ≥16 years on perceived loneliness and lifetime and past 12-month suicide ideation and attempts. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of CMD. Logistic regression analysis was used to examine these associations.

RESULTS

Loneliness was associated with suicidal behavior. Although adjusting for CMDs attenuated associations, higher levels of loneliness were still significantly associated with suicidal ideation and suicide attempts with odds ratios (OR) for those in the most severe loneliness category ranging from 3.45 (lifetime suicide attempt) to 17.37 (past 12-month suicide attempt). Further analyses showed that ORs for suicidal behavior were similar for individuals who were lonely without CMDs, and for those respondents with CMDs who were not lonely. Lonely individuals with CMDs had especially elevated odds for suicidal ideation.

LIMITATIONS

This study used cross-sectional data and a single-item measure to obtain information on loneliness.

CONCLUSION

Loneliness is associated with suicidal behavior in the general adult population. This highlights the importance of efforts to reduce loneliness in order to mitigate its harmful effects on health and well-being.

Prevalence and correlates of loneliness among Chinese service industry migrant workers: A cross-sectional survey

Chinese rural-to-urban migrant workers (MWs) who are employed in service industry are a rapidly growing population in urban China. Like other MWs, service industry MWs (SIMWs) are generally excluded from the mainstream of city societies, but unlike other MWs, they are more marginalized in cities. Social isolation increases the feelings of loneliness; however, there are little empirical data on the epidemiology of loneliness of SIMWs. The present study aimed to investigate the prevalence and associated factors of loneliness among SIMWs in Shenzhen, China. By using respondent-driven sampling, 1979 SIMWs were recruited and administered with standardized questionnaires to collect data on sociodemographics, physical health, and migration-related characteristics. Loneliness and social support were measured with a single-item self-report question "Do you feel lonely often?" and Multidimensional Scale of Perceived Social Support (MSPSS), respectively. 18.3% of SIMWs reported feeling lonely often. Being aged 60 years or older (odds ratio [OR] = 2.30), marital status of "others" (OR = 2.77), being physically ill in the last 2 weeks (OR = 1.46), migrating alone (OR = 1.97), working >8 hours/day (OR = 1.06), MSPSS inside family subscale score ≤18 (OR = 1.80), and MSPSS outside family subscale score ≤38 (OR = 1.50) were significantly associated with increased risk of loneliness in SIMWs. Loneliness is prevalent in Chinese SIMWs and should be seen as a major public health issue. The high prevalence and many negative health consequences of loneliness highlight the importance of routine screening, evaluation, and treatment of loneliness in this vulnerable population.

Explaining the gender difference in self-rated health among university students in Egypt

In this study the authors assessed gender differences in the relationships between self-rated health (SRH) and demographic factors, physical health, health service use, infections, a variety of symptoms and health conditions, and wider well-being features. A self-administered questionnaire was administered to 3,271 students at Assiut University, Egypt during 2009-2010. Multiple logistic regression was used (with excellent/very good SRH as dependent variable) to assess the variables that might explain the gender difference in SRH. Females had more symptoms, infectious diseases/illness periods, substantially lower quality of life, and more burdens, although their health awareness and satisfaction with social support were higher than males. The unadjusted odds ratio (OR) suggested that females were less likely than males to rate their SRH as excellent/very good [OR 0.56, 95% confidence interval (CI) 0.47-0.68]. Adjusting only for relevant physical health and health service use variables, the OR for excellent/very good SRH for females increased, but nevertheless still remained significantly lower than that of males. With further adjustment for physical health, health service use, and also for wider well-being variables, the gender difference in SRH became no longer statistically significant. Poorer physical health indicators and a lower level of wider well-being features explained the lower SRH among female Egyptian university students. Health promotion and prevention programs should consider these factors in attempting to address gender health disparities.

Pet ownership and physical health

PURPOSE OF REVIEW

Pet ownership and brief human-animal interactions can serve as a form of social support and convey a host of beneficial psychological and physiological health benefits. This article critically examines recent relevant literature on the pet-health connection.

RECENT FINDINGS

Cross-sectional studies indicate correlations between pet ownership and numerous aspects of positive health outcomes, including improvements on cardiovascular measures and decreases in loneliness. Quasi-experimental studies and better controlled experimental studies corroborate these associations and suggest that owning and/or interacting with a pet may be causally related to some positive health outcomes.

SUMMARY

The value of pet ownership and animal-assisted therapy (AAT), as a nonpharmacological treatment modality, augmentation to traditional treatment, and healthy preventive behavior (in the case of pet ownership), is starting to be realized. However, more investigations that employ randomized controlled trials with larger sample sizes and investigations that more closely examine the underlying mechanism of the pet-health effect, such as oxytocin, are needed.