DEFACTUM - Public Health and Health Service Research, Central Denmark Region, Denmark.
Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Denmark.
Scand J Public Health. 2024 Jun;52(4):410-418. doi: 10.1177/14034948231151716. Epub 2023 Feb 16.
Prolonged loneliness and severe stress are increasingly recognised as public health concerns and considered risk factors for mental disorders, somatic illnesses and mortality. Loneliness and perceived stress also often co-occur; however, their longitudinal relation remains unclear. To the best of our knowledge, this is the first study aiming to investigate the longitudinal relation between loneliness and perceived stress independently of cross-sectional associations and time effects.
Designed as a population-based cohort study with repeated measurements, the present study included individuals aged 16-80 years at baseline who participated in the Danish National Health Survey ('How are you?') in 2013 and 2017 ( = 10,159; response rate = 50%). Structural equation modelling was used to examine associations between loneliness and perceived stress in the total sample and across age groups (i.e., 16-29, 30-64 and 65-80 years).
The models indicated bidirectional relations between loneliness and perceived stress. The standardized cross-lagged path from loneliness to perceived stress (β: 0.12, 95% confidence interval (CI) (0.08, 0.16), < 0.001) and from perceived stress to loneliness (β: 0.12, 95% CI (0.07, 0.16), < 0.001) both corresponded to small effect sizes in the total sample. Additionally, the results indicated strong cross-sectional associations, especially among adolescents and young adults (16-29 years), and high temporal stability, especially among the elderly (65-80 years).
Loneliness and perceived stress mutually predict each other over time. The finding of both substantial bidirectional and cross-sectional associations demonstrates an interdependence between loneliness and perceived stress that may be relevant to consider in future interventions.
长期孤独和严重压力日益被认为是公共卫生关注的问题，并被认为是精神障碍、躯体疾病和死亡率的风险因素。孤独和感知到的压力也经常同时发生；然而，它们的纵向关系尚不清楚。据我们所知，这是第一项旨在独立于横断面关联和时间效应研究孤独感和感知到的压力之间纵向关系的研究。
本研究设计为一项基于人群的队列研究，进行重复测量，基线时纳入年龄在 16-80 岁之间的个体，他们在 2013 年和 2017 年参加了丹麦国家健康调查（“你好吗？”）（=10159；应答率=50%）。结构方程模型用于在总样本和各年龄组（即 16-29、30-64 和 65-80 岁）中检查孤独感和感知到的压力之间的关联。
模型表明孤独感和感知到的压力之间存在双向关系。从孤独感到感知到的压力的标准化交叉滞后路径（β：0.12，95%置信区间（CI）（0.08，0.16），<0.001）和从感知到的压力到孤独感的路径（β：0.12，95%CI（0.07，0.16），<0.001）在总样本中对应于小的效应量。此外，结果表明存在强烈的横断面关联，尤其是在青少年和年轻人（16-29 岁）中，以及高的时间稳定性，尤其是在老年人（65-80 岁）中。
孤独感和感知到的压力在时间上相互预测。存在实质性的双向和横断面关联的发现表明，孤独感和感知到的压力之间存在相互依存关系，这在未来的干预中可能需要考虑。
