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Pengpid S, Peltzer K. Loneliness and associated factors among middle-aged and older adults: cross-sectional and longitudinal survey results from the HAALSI cohort in South Africa. Aging Ment Health 2024; 28:1179-1187. [PMID: 38726552 DOI: 10.1080/13607863.2024.2345777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/15/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES Longitudinal studies on chronic loneliness and before and during the COVID-19 pandemic are lacking in Africa. The study aimed to estimate the prevalence and associated factors of loneliness and chronic loneliness using cross-sectional and longitudinal data from middle-aged and older adults from rural South Africa. METHOD The analysis utilized data from the South African 7-year longitudinal Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (analytic sample: n = 3,418, aged 40 years and older). Loneliness was assessed with a single and 3-item measure. RESULTS The proportion of loneliness was 19.5% in the 2021/2022 survey, the incidence of chronic loneliness (having loneliness in wave 2 and 3, and free of loneliness in wave 1) was 18.9%, and the 7-year incidence of loneliness was 41.0%. Comparing the 2019 (pre-COVID-19) to 2021/2022 (during COVID-19 pandemic) surveys participants experienced a significant reduction of loneliness. In cross-sectional and/or longitudinal analyses, we found that younger age, living alone, food insecurity, lack of social engagement, depressed mood, poor life satisfaction, poor sleep quality, impaired cognition, poor self-rated health, functional disability, underweight, obesity, and not living with HIV were associated with a higher prevalence, incidence and/or increases in loneliness. CONCLUSION One in five aging adults had acute or chronic loneliness. Several social, mental, and physical health factors were identified as associated with loneliness.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Grigorian K, Östberg V, Raninen J, Brolin Låftman S. Loneliness, belonging and psychosomatic complaints across late adolescence and young adulthood: a Swedish cohort study. BMC Public Health 2024; 24:642. [PMID: 38424596 PMCID: PMC10903051 DOI: 10.1186/s12889-024-18059-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Loneliness and belonging refer to social connectedness and are associated with young people's health; however, the relationship between these constructs and their impact on health is still being discussed. A dual continuum model of belonging and loneliness has been suggested, consisting of four groups depending on the state of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially indifferent (low loneliness, low belonging), socially searching (high loneliness, high belonging), and socially distressed (high loneliness, low belonging). The aim of this study is to examine loneliness and belonging in a Swedish sample of 17-18-years-olds who were followed over 3 years, and the associations that these aspects share with young people's psychosomatic complaints during these ages. METHODS Swedish cohort data collected among late adolescents (age 17-18 in 2019) who were followed up in young adulthood (age 20-21 in 2022) (n = 2684) was used to examine the associations between loneliness, belonging, and psychosomatic complaints. Loneliness and belonging were measured by single items and the cross-combinations of these. Three psychosomatic complaints were assessed: stomach ache, headache, and difficulties falling asleep, and a summary index was calculated. RESULTS Linear regression analyses showed that loneliness was positively and belonging was negatively cross-sectionally associated with psychosomatic complaints. The socially fulfilled group reported fewer psychosomatic complaints compared to all other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Additional adjustment for sociodemographic characteristics barely affected the estimates. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, the only statistically significant difference in subsequent psychosomatic complaints was found between the socially fulfilled and the socially distressed groups. CONCLUSIONS Loneliness and belonging (separately and the cross-combinations of these) were cross-sectionally associated with psychosomatic complaints in late adolescence and in young adulthood. Prospectively, only the most vulnerable group in the dual continuum model, the socially distressed group, experienced more psychosomatic complaints than the socially fulfilled group, indicating a temporal relationship. Knowledge about the more nuanced links may be useful for developing specific public health recommendations and interventions for youth, targeting the most vulnerable groups.
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Affiliation(s)
- Karina Grigorian
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
| | - Viveca Östberg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Jonas Raninen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Sara Brolin Låftman
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Green MF, Wynn JK, Eisenberger NI, Horan WP, Lee J, McCleery A, Miklowitz DJ, Reavis EA, Reddy LF. Social cognition and social motivation in schizophrenia and bipolar disorder: are impairments linked to the disorder or to being socially isolated? Psychol Med 2024:1-9. [PMID: 38314526 DOI: 10.1017/s0033291724000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND People with schizophrenia on average are more socially isolated, lonelier, have more social cognitive impairment, and are less socially motivated than healthy individuals. People with bipolar disorder also have social isolation, though typically less than that seen in schizophrenia. We aimed to disentangle whether the social cognitive and social motivation impairments observed in schizophrenia are a specific feature of the clinical condition v. social isolation generally. METHODS We compared four groups (clinically stable patients with schizophrenia or bipolar disorder, individuals drawn from the community with self-described social isolation, and a socially connected community control group) on loneliness, social cognition, and approach and avoidance social motivation. RESULTS Individuals with schizophrenia (n = 72) showed intermediate levels of social isolation, loneliness, and social approach motivation between the isolated (n = 96) and connected control (n = 55) groups. However, they showed significant deficits in social cognition compared to both community groups. Individuals with bipolar disorder (n = 48) were intermediate between isolated and control groups for loneliness and social approach. They did not show deficits on social cognition tasks. Both clinical groups had higher social avoidance than both community groups. CONCLUSIONS The results suggest that social cognitive deficits in schizophrenia, and high social avoidance motivation in both schizophrenia and bipolar disorder, are distinct features of the clinical conditions and not byproducts of social isolation. In contrast, differences between clinical and control groups on levels of loneliness and social approach motivation were congruent with the groups' degree of social isolation.
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Affiliation(s)
- Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Los Angeles, CA, USA
| | - Jonathan K Wynn
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Los Angeles, CA, USA
| | | | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Karuna Therapeutics, Boston, MA, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amanda McCleery
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - David J Miklowitz
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Eric A Reavis
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Los Angeles, CA, USA
| | - L Felice Reddy
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Los Angeles, CA, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
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Pengpid S, Peltzer K, Anantanasuwong D. Longitudinal associations of loneliness with mental ill-health, physical ill-health, lifestyle factors and mortality in ageing adults in Thailand. BMC Psychiatry 2023; 23:855. [PMID: 37978470 PMCID: PMC10656829 DOI: 10.1186/s12888-023-05263-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/08/2023] [Indexed: 11/19/2023] Open
Abstract
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.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Dararatt Anantanasuwong
- Center for Aging Society Research (CASR), National Institute of Development Administration (NIDA), Bangkapi Bangkok, Thailand
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Barbieri V, Piccoliori G, Mahlknecht A, Plagg B, Ausserhofer D, Engl A, Wiedermann CJ. Adolescent Mental Health during the COVID-19 Pandemic: The Interplay of Age, Gender, and Mental Health Outcomes in Two Consecutive Cross-Sectional Surveys in Northern Italy. Behav Sci (Basel) 2023; 13:643. [PMID: 37622783 PMCID: PMC10451173 DOI: 10.3390/bs13080643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/26/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the mental health and well-being of adolescents. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health among adolescents in Northern Italy by comparing cross-sectional surveys conducted in 2021 and 2022, with a particular focus on the influence of age and gender. The sample included adolescents aged 11-19 years from public schools in South Tyrol. Validated psychometric instruments were used to assess HRQoL, anxiety and depression symptoms, and psychosomatic complaints. Sociodemographic variables, COVID-19 burden, and pandemic-related factors were measured. Statistical analyses included chi-square tests, correlation coefficients, and logistic regression analyses. The results indicated that while the self-reported burden of adolescents decreased significantly in 2022 (n = 1885) compared to 2021 (n = 1760), there were no significant differences in symptoms of anxiety, depressive symptoms, low HRQoL, and increased psychosomatic complaints between the two surveys for both early and late adolescents. Females consistently had higher percentages for all outcome variables, and symptoms of anxiety increased with age in females, but not in males. Both genders experienced an increase in depressive symptoms and low HRQoL with age. The co-occurrence of mental health outcomes was observed, suggesting overlapping patterns among anxiety, depression, low HRQoL, and psychosomatic complaints. These findings underscore the intricate relationship between age, gender, and mental health outcomes among adolescents during the pandemic. It is important to recognize that late adolescents may exhibit distinct vulnerabilities and may require tailored support approaches to address their specific mental health challenges, differing from those needed for early adolescents.
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Affiliation(s)
- Verena Barbieri
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Barbara Plagg
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
- Faculty of Education, Free University of Bolzano, 39100 Bolzano, Italy
| | - Dietmar Ausserhofer
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Christian J. Wiedermann
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology—Tyrol, 6060 Hall, Austria
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Martin E, Schoeler T, Pingault JB, Barkhuizen W. Understanding the relationship between loneliness, substance use traits and psychiatric disorders: A genetically informed approach. Psychiatry Res 2023; 325:115218. [PMID: 37146462 PMCID: PMC10636586 DOI: 10.1016/j.psychres.2023.115218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/07/2023]
Abstract
Loneliness is a common, yet distressing experience associated with adverse outcomes including substance use problems and psychiatric disorders. To what extent these associations reflect genetic correlations and causal relationships is currently unclear. We applied Genomic Structural Equation Modelling (GSEM) to dissect the genetic architecture between loneliness and psychiatric-behavioural traits. Included were summary statistics from 12 genome-wide association analyses, including loneliness and 11 psychiatric phenotypes (range N: 9,537 - 807,553). We first modelled latent genetic factors amongst the psychiatric traits to then investigate potential causal effects between loneliness and the identified latent factors, using multivariate genome-wide association analyses and bidirectional Mendelian randomization. We identified three latent genetic factors, encompassing neurodevelopmental/mood conditions, substance use traits and disorders with psychotic features. GSEM provided evidence of a unique association between loneliness and the neurodevelopmental/mood conditions latent factor. Mendelian randomization results were suggestive of bidirectional causal effects between loneliness and the neurodevelopmental/mood conditions factor. These results imply that a genetic predisposition to loneliness may elevate the risk of neurodevelopmental/mood conditions, and vice versa. However, results may reflect the difficulty of distiguishing between loneliness and neurodevelopmental/mood conditions, which present in similar ways. We suggest, overall, the importance of addressing loneliness in mental health prevention and policy.
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Affiliation(s)
- Ellen Martin
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Tabea Schoeler
- Division of Psychology and Language Sciences, University College London, London, United Kingdom; Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London, London, United Kingdom; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom
| | - Wikus Barkhuizen
- Division of Psychology and Language Sciences, University College London, London, United Kingdom.
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Pengpid S, Peltzer K. Prevalence and associated factors of incident and persistent loneliness among middle-aged and older adults in Thailand. BMC Psychol 2023; 11:70. [PMID: 36918991 PMCID: PMC10015912 DOI: 10.1186/s40359-023-01115-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
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.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand. .,Department of Psychology, University of the Free State, PO Box 339 (40), 9300, Bloemfontein, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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