The bidirectional relationship between loneliness and common mental disorders in adults: findings from a longitudinal population-based cohort study
The bidirectional relationship between loneliness and common mental disorders in adults: findings from a longitudinal population-based cohort study
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DOI：
10.1007/s00127-019-01778-8
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发表时间：
2020-10-01
影响因子：
4.4
通讯作者：
ten Have, Margreet
中科院分区：
文献类型：
--
作者：
Nuyen, Jasper;Tuithof, Marlous;ten Have, Margreet
研究目的：孤独与常见精神障碍（CMD）之间双向关联的纵向人群研究有限。使用3年的随访数据，本研究探讨了成年人的孤独是否会增加轻度-中度或重度CMD的发病和持续性风险;以及轻度-中度或重度CMD是否是孤独发病和持续性的风险因素。方法数据来自荷兰心理健康调查和发病率研究-2的第二波（“基线”）和第三波（3年随访），这是一项针对18-64岁成年人代表性队列的前瞻性研究。使用复合国际诊断访谈3.0评估10个月的CMD及其严重程度，并使用De Jong Gierveld孤独量表评估当前的孤独感。多变量分析控制了几个潜在的混杂因素。结果在基线时无CMD的成人中，孤独症可预测随访时重度CMD的发生，而在基线时有CMD的成人中，孤独症可增加随访时持续重度CMD的风险。相反，严重的CMD可以预测基线时非孤独成年人在随访时出现孤独感，但与基线时孤独成年人在随访时出现持续孤独感无关。在控制了基线时的社会支持感知后，观察到的关联仍然显着，除了孤独和持续严重CMD之间的关系。孤独感与轻度-中度CMD之间没有纵向关系。结论应重视CMD患者和非CMD患者的孤独感。需要进一步的研究来更好地了解孤独和CMD之间观察到的关联的机制，以制定成功的干预措施。
Purpose Limited longitudinal population-based research exists on the bidirectional association between loneliness and common mental disorders (CMDs). Using 3-year follow-up data, this study examined whether loneliness among adults increases the risk for onset and persistence of mild-moderate or severe CMD; and whether mild-moderate or severe CMD is a risk factor for onset and persistence of loneliness. Methods Data were used from the second ('baseline') and third (3-year follow-up) waves of the Netherlands Mental Health Survey and Incidence Study-2, a prospective study of a representative cohort of adults aged 18-64 years. Twelve-month CMDs and their severity were assessed with the Composite International Diagnostic Interview 3.0, and current loneliness using the De Jong Gierveld Loneliness Scale. Multivariate analyses were controlled for several potential confounders. Results Loneliness predicted onset of severe CMD at follow-up in adults without CMDs at baseline, and increased risk for persistent severe CMD at follow-up in those with CMD at baseline. Conversely, severe CMD predicted onset of loneliness at follow-up in non-lonely adults at baseline, but was not associated with persistent loneliness at follow-up in lonely adults at baseline. Observed associations remained significant after controlling for perceived social support at baseline, except for the relationship between loneliness and persistent severe CMD. No longitudinal relationships were observed between loneliness and mild-moderate CMD. Conclusions Attention should be paid to loneliness, both in adults with and without CMD. Further research is needed to better understand the mechanisms underlying the observed associations between loneliness and CMDs to develop successful interventions.