Müller Julia, Elsaesser Moritz, Berger Ruben, Müller Wiebke, Hellmich Martin, Zehender Nadine, Riedel-Heller Steffi, Bewernick Bettina H, Wagner Michael, Frölich Lutz, Peters Oliver, Domschke Katharina, Jessen Frank, Hautzinger Martin, Dafsari Forugh S, Schramm Elisabeth
Department of Psychiatry and Psychotherapy (JM, ME, NZ, KD, ES), Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Psychiatry and Psychotherapy (RB), Faculty of Medicine, University of Bonn, Bonn, Germany.
Am J Geriatr Psychiatry. 2025 Jul;33(7):717-729. doi: 10.1016/j.jagp.2025.01.003. Epub 2025 Jan 21.
This study investigates the association of loneliness during the COVID-19 pandemic and the course of depressive, anxiety and sleep symptoms after psychological treatment in older adults.
During the first wave of the pandemic in 2020, we assessed additional, original data of 132 participants aged ≥60 years who had completed psychological treatment for late-life depression (LLD) in the context of a multicenter, randomized controlled trial (CBT-late). We measured loneliness using the UCLA Loneliness Scale. Depression, anxiety and sleep symptoms were assessed using the Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory (GAI), and Insomnia Severity Index (ISI).
Participants with higher loneliness scores (n = 44) experienced a significant worsening of depressive and anxiety symptoms during the pandemic (estimated marginal mean difference (emmd) of change in GDS between post-treatment and COVID-19 visit: GDS= -4.61, [95% CI: -6.97 to -2.26], GAI= -2.21, [95% CI: -3.76 to -0.65]), while those with low to moderate loneliness (n = 72) maintained stable mild symptoms (GDS= -1.39, [95% CI: -3.00 to 0.22], GAI= -0.49, [95% CI: -1.69 to 0.72]). All patients reported increased sleep disturbances during the pandemic regardless of loneliness, while remaining in the range for sub-threshold insomnia.
Our results suggest an association of significant loneliness during the COVID-19 pandemic and a clinically relevant worsening of depressive and anxiety symptoms in older adults. Loneliness assessments and interventions may be incorporated into treatments for LLD, particularly during pandemics or other crises.
本研究调查了新冠疫情期间老年人的孤独感与心理治疗后抑郁、焦虑和睡眠症状病程之间的关联。
在2020年疫情的第一波期间，我们评估了132名年龄≥60岁参与者的额外原始数据，这些参与者在一项多中心随机对照试验（CBT-老年组）的背景下完成了针对老年期抑郁症（LLD）的心理治疗。我们使用加州大学洛杉矶分校孤独感量表测量孤独感。使用老年抑郁量表（GDS）、老年焦虑量表（GAI）和失眠严重指数（ISI）评估抑郁、焦虑和睡眠症状。
孤独感得分较高的参与者（n = 44）在疫情期间抑郁和焦虑症状显著恶化（治疗后至新冠疫情访视期间GDS变化的估计边际均值差异（emmd）：GDS = -4.61，[95%置信区间：-6.97至-2.26]，GAI = -2.21，[95%置信区间：-3.76至-0.65]），而孤独感低至中度的参与者（n = 72）保持稳定轻微症状（GDS = -1.39，[95%置信区间：-3.00至0.22]，GAI = -0.49，[95%置信区间：-1.69至0.72]）。所有患者在疫情期间均报告睡眠障碍增加，无论孤独感如何，且仍处于亚阈值失眠范围内。
我们的结果表明，新冠疫情期间严重的孤独感与老年人抑郁和焦虑症状的临床相关恶化之间存在关联。孤独感评估和干预可能纳入LLD的治疗中，尤其是在疫情或其他危机期间。
