Park Caroline, Majeed Amna, Gill Hartej, Tamura Jocelyn, Ho Roger C, Mansur Rodrigo B, Nasri Flora, Lee Yena, Rosenblat Joshua D, Wong Elizabeth, McIntyre Roger S
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
Psychiatry Res. 2020 Dec;294:113514. doi: 10.1016/j.psychres.2020.113514. Epub 2020 Oct 19.
The primary objective was to evaluate the comparative effects of loneliness on multiple distinct health outcomes. The literature was qualitatively reviewed to identify loneliness risk factors, explore mechanisms, and discuss potential evidence-based interventions for targeting loneliness. 114 identified studies were systematically reviewed and analyzed to examine for associations between loneliness (as measured by the UCLA Loneliness or de Jong Gierveld Loneliness Scales) and one or more health outcome(s). Health outcomes were broadly defined to include measures of mental health (i.e., depression, anxiety, suicidality, general mental health), general health (i.e., overall self-rated health), well-being (i.e., quality of life, life satisfaction), physical health (i.e., functional disability), sleep, and cognition. Loneliness had medium to large effects on all health outcomes, with the largest effects on mental health and overall well-being; however, this result may have been confounded by the breadth of studies exploring the association between loneliness and mental health, as opposed to other health outcomes. A significant effect of gender on the association between loneliness and cognition (i.e., more pronounced in studies with a greater proportion of males) was also observed. The adequate training of health care providers to perceive and respond to loneliness among patients should be prioritized.
主要目标是评估孤独对多种不同健康结果的比较影响。对文献进行了定性综述，以确定孤独的风险因素、探索机制，并讨论针对孤独的潜在循证干预措施。对114项已确定的研究进行了系统综述和分析，以检验孤独（通过加州大学洛杉矶分校孤独量表或德容·吉尔维尔德孤独量表测量）与一种或多种健康结果之间的关联。健康结果被广泛定义为包括心理健康指标（即抑郁、焦虑、自杀倾向、总体心理健康）、总体健康（即总体自评健康）、幸福感（即生活质量、生活满意度）、身体健康（即功能残疾）、睡眠和认知。孤独对所有健康结果都有中度到较大的影响，对心理健康和总体幸福感的影响最大；然而，这一结果可能因探索孤独与心理健康之间关联的研究范围广泛而受到混淆，与其他健康结果相比。还观察到性别对孤独与认知之间的关联有显著影响（即在男性比例较高的研究中更为明显）。应优先对医疗保健提供者进行充分培训，使其能够识别并应对患者的孤独感。
