Hysing Mari, Petrie Keith J, Harvey Allison G, Sivertsen Børge
Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.
Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
Soc Psychiatry Psychiatr Epidemiol. 2025 Sep 17. doi: 10.1007/s00127-025-02989-y.
Loneliness is an increasing public health concern among young adults. There is insufficient prior research on the association between loneliness and depressive disorder among students in higher education.
This prospective population-based cohort study from Norway invited all full-time students aged 18-35 to participate in the 2022 Students' Health and Wellbeing Study (SHoT). Of the 53,362 respondents, a subgroup of 16,418 students was randomly selected for diagnostic follow-up, with valid data from 10,460 participants. Loneliness was assessed in 2022 using the Three-Item Loneliness Scale (T-ILS) and Major Depressive Episodes (MDE) were assessed in 2023 using a self-administered electronic version of the Composite International Diagnostic Interview, version 5.0 (CIDI 5.0).
A clear dose-response relationship was observed: students in the highest loneliness quintile had a substantially increased risk of MDE one year later. After adjusting for age and baseline anxiety and depression symptoms, the relative risk (RR) for MDE in the highest versus lowest T-ILS quintile was 2.02 (95% CI: 1.58-2.63) for females and 2.64 (95% CI: 1.63-4.49) for males-representing a ~ 70-75% reduction from unadjusted estimates. The overall prevalence of MDE was 21.1% in females and 11.2% in males. Formal interaction analyses indicated a statistically significant multiplicative interaction by sex, but no evidence of additive interaction.
Loneliness is a strong and independent predictor of MDE in young adults, even after accounting for baseline mental health. Targeting loneliness may be important for preventing depression in university populations.
孤独感日益成为年轻成年人的公共卫生问题。此前关于高等教育学生孤独感与抑郁症之间关联的研究不足。
这项来自挪威的基于人群的前瞻性队列研究邀请了所有年龄在18 - 35岁的全日制学生参与2022年学生健康与幸福研究（SHoT）。在53362名受访者中，随机抽取了16418名学生作为诊断随访亚组，其中10460名参与者有有效数据。2022年使用三项孤独感量表（T - ILS）评估孤独感，2023年使用综合国际诊断访谈5.0版（CIDI 5.0）的自我管理电子版评估重度抑郁发作（MDE）。
观察到明显的剂量反应关系：孤独感最高五分位数组的学生在一年后患MDE的风险大幅增加。在调整年龄和基线焦虑及抑郁症状后，女性中T - ILS最高与最低五分位数组相比，MDE的相对风险（RR）为2.02（95%CI：1.58 - 2.63），男性为2.64（95%CI：1.63 - 4.49），相较于未调整估计值降低了约70 - 75%。MDE的总体患病率女性为21.1%，男性为11.2%。形式交互分析表明存在显著的性别乘性交互作用，但无相加交互作用的证据。
孤独感是年轻成年人MDE的一个强有力且独立的预测因素，即使在考虑基线心理健康状况之后。针对孤独感可能对预防大学生抑郁症很重要。
