Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan; Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
J Adolesc Health. 2023 Jun;72(6):906-913. doi: 10.1016/j.jadohealth.2022.12.029. Epub 2023 Feb 10.
Emerging studies address adolescent loneliness a public health problem due to its negative associations with adverse health. However, evidence concerning adolescent loneliness and its correlation in nonwestern, low- and middle-income countries is scarce. This study examined the prevalence of loneliness and its correlates (i.e., sex, bullying victimization, and peer support) across 70 countries from five WHO regions.
Data were collected from the Global School-based Student Health Survey of children aged 13-17 (2003-2018) years. Loneliness was defined as feeling lonely most of the time or always in the past 12 months based on self-reports. The prevalence of loneliness was estimated, and multivariable logistic regression ascertained prevalence ratios of correlates by country. Meta-analysis was used to examine regional and overall pooled estimates.
Among the 248,017 students included in the study, the overall prevalence of loneliness was 11.7% (95% confidence interval (CI): 10.6-12.7), with significant variations across countries. Girls (vs. boys prevalence ratio (PR = 1.4 95% CI: 1.3-1.4), students who experienced bullying victimization (PR = 2.2, 95% CI: 2.1-2.3), and students who reported a lack of close friends (PR = 1.8, 95% CI: 1.7-1.9) were at increased risk of experiencing loneliness. There was significant heterogeneity between countries for sex and lack of close friends but not for bullying victimization.
Adolescent loneliness is prevalent globally, especially in Africa and the Eastern Mediterranean. The considerable heterogeneity in its prevalence and correlates suggest that tailoring to the country context may benefit policy initiatives. Bullying may be a common intervention target in all countries.
由于青少年孤独与不良健康之间存在负面关联，因此越来越多的研究将其视为公共卫生问题。然而，关于非西方、中低收入国家青少年孤独及其相关性的证据却很少。本研究调查了五个世界卫生组织区域 70 个国家青少年孤独的流行率及其相关因素（即性别、受欺凌和同伴支持）。
数据来自全球范围内 13-17 岁儿童的“全球学校学生健康调查”（2003-2018 年）。根据自我报告，将孤独感定义为过去 12 个月中大多数时间或总是感到孤独。评估孤独感的流行率，并通过多变量逻辑回归确定各国相关因素的流行率比。使用荟萃分析来检验区域和总体综合估计值。
在纳入本研究的 248017 名学生中，孤独感的总体流行率为 11.7%（95%置信区间[CI]：10.6-12.7），各国之间存在显著差异。与男生相比，女生（比值比[PR] = 1.4，95% CI：1.3-1.4）、遭受欺凌的学生（PR = 2.2，95% CI：2.1-2.3）和报告缺乏亲密朋友的学生（PR = 1.8，95% CI：1.7-1.9）发生孤独感的风险增加。性别和缺乏亲密朋友方面各国之间存在显著异质性，但在遭受欺凌方面则没有。
青少年孤独感在全球范围内普遍存在，尤其是在非洲和东地中海地区。其流行率和相关性存在很大的异质性，这表明针对国家情况进行调整可能会有益于政策举措。欺凌可能是所有国家的共同干预目标。
