Social Isolation Research Articles

Association Between Objective Social Isolation and Unmet Medical Needs: A Nationwide Cross-sectional Study in South Korea.

The aim of this study was to analyze the relationship between objective social isolation (SI) and unmet medical needs (UMN) in adults aged 19 and older. A cross-sectional analysis was conducted of 208,619 adults aged 19 and older, excluding missing data, using the 2019 Korea Community Health Survey. To analyze the association between objective SI and UMN, the chi-square test and logistic regression analysis were performed. The prevalence of UMN was 1.14 times higher (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06-1.23) among those with SI than among those without SI, and the OR for groups with 5 SI types was 2.77 (95% CI, 1.86-4.12) compared to those with no SI types. In addition, a stratified analysis by age group showed that the association between SI and UMN existed even in groups under 64 years old. However, among those aged 65 and older, SI was associated with an OR of 1.53 (95% CI, 1.37-1.71) for UMN compared to non-SI. As the number of SI types increased, the prevalence of UMN also increased, indicating a strong association between SI and UMN in older adults. This study found that individuals with SI experienced UMN due to fear and anxiety about interpersonal relationships. Therefore, based on the results of this cross-sectional study, it is necessary to investigate the causal relationship between SI and UMN through future longitudinal data.

Effects of Long COVID on Psycho-Physical Conditions in the Italian Population: A Statistical and Large Language Model Combined Description.

Long COVID refers to the persistence or development of signs and symptoms well after the acute phase of COVID-19. To investigate the long-term outcomes of the SARS-CoV-2 infection in terms of psychological, social, and relational consequences within the Italian population. We conducted an observational, cross-sectional, and multicenter study using an online questionnaire distributed to a sample of the Italian population. By utilizing the Short Form 12 Health Survey (SF-12) and the Hikikomori scale, we assessed perceived quality of life and social isolation, respectively. The questionnaire also included an open-answer question: "What will you remember about the pandemic period?". We used generative artificial intelligence to analyze and summarize the corresponding answers. A total of 1097 people participated in this study. A total of 79.3% (n = 870) of participants declared that they had been hospitalized and 62.8% (n = 689) received home care. Physical symptoms included headaches (43%, n = 472) and asthma (30.4%, n = 334). Additionally, 29.2% (n = 320) developed an addiction during the pandemic and, among these, 224 claimed internet addiction while 73 declared an emotional addiction. Furthermore, 51.8% (n = 568) experienced limitations in carrying out daily life activities. According to the Hikikomori scale, participants with positive SARS-CoV-2 infection exhibited higher levels of isolation compared to the others (p < 0.001). Participants without COVID-19 showed higher levels of emotional support (p < 0.001). Our semiautomatic analysis of the open-ended responses, obtained by a procedure based on a free large language model, allowed us to deduce and summarize the main feelings expressed by the interviewees regarding the pandemic. The data collected emphasize the urgent need to investigate the consequences of long COVID in order to implement interventions to support psychological well-being.

The effects of social capital deprivation for wellbeing: Evidence from the Covid-19 pandemic

The paper explores the relationship between the Covid-19 pandemic, subjective wellbeing and social capital in the UK. I exploit the pandemic as a quasi-natural experiment of an exogenously induced reduction of social capital as an explanation of the frequently documented reduction in wellbeing during the pandemic period. Differently from the literature, results show that after the onset of the pandemic - when the imposition of restrictions to social interactions occurred - both mental health and life satisfaction substantially decreased, and this decrease was larger for the people who reported having higher pre-pandemic social capital. Results also show however that their wellbeing decrease was not high enough to fully overturn the wellbeing gap usually in their favour. This suggests that the positive effects of social capital for wellbeing are via at least two pathways: in-person social interactions and via the value of having social networks. These results contribute to the literature on the relationship between social capital and wellbeing, as well as the one on the effects of the pandemic for mental health and life satisfaction. Policy implications include investing in social capital to increase overall populations’ wellbeing; and, during epidemiological crises, facilitating online psychological support to hamper the negative effects of social isolation, and campaigning to encourage people to keep as much as possible in touch with loved ones and their communities via online social networks and online events to prevent a further degradation of the quantity and quality of social interactions.

Family Violence Against Children and Parents’ Social Support during the COVID-19 Pandemic: A Cohort Study

Amid the COVID-19 pandemic, several experts have raised concerns over an increased risk of family violence. The proximity between confined family members and social isolation fostered tensions, making families more vulnerable. The first objective of this study was to describe the evolution of family violence against children (psychological aggression and corporal punishment) and parents' social support during the COVID-19 pandemic. The second objective was to determine the contribution of parents’ social support to the evolution of family violence against children between two measurement times. Participants included parents living with at least one child between 0 and 17 years old (N = 514) from the broader longitudinal prospective cohort study, My Life and the Pandemic in Quebec (MAVIPAN) from Quebec, Canada. Family violence against children and social support were measured twice (2020 and 2021) with a web-based survey. Most parents reported no family violence against children. Psychological aggression significantly decreased between the two measurement times (p = .003). Corporal punishment and social support remained stable. Social support was a significant predictor of the evolution of psychological aggression. Participants reporting a lower level of perceived social support at baseline were more likely to report psychological aggression at both measurement times, compared to the reference group of parents reporting none (p = .002; OR = 0.914). Social support emerged as a protective factor when psychological aggression towards children is chronic in a family. This study contributes to the growing literature documenting the experience of parents during the COVID-19 pandemic.

Influence of Social Media on Physicians' Behaviors

The influence of social media on health-related behaviors is a major research topic. Social media platforms play a crucial role in disseminating health information, thus influencing individuals' perceptions, attitudes, and behaviors towards health and healthcare. These platforms allow quick access to a large amount of information but can also convey inaccurate or misleading information. Social media also enables individuals to share their personal health experiences, which can influence the behavior of other users. Health awareness and promotion campaigns conducted on social media can have a significant impact by reaching a wide audience. Additionally, social media platforms have become popular spaces for healthcare professionals and healthcare organizations to interact with patients, answer their questions, and provide medical advice. However, excessive use of social media can also have negative effects on mental health, including contributing to anxiety, depression, and social isolation. It is therefore crucial to understand how social media shapes health-related behaviors in order to promote healthy behaviors and counter misinformation.

Research on the Impact of Anime on the Mental Health of Adolescents

This paper aims to explore the impact of anime on the mental health of adolescents, analyzing both its positive and negative influences, as well as corresponding management and guidance strategies. Through an overview of the prevalence of anime in the lives of adolescents, the importance of adolescent mental health, and the potential impact mechanisms of anime on their mental health, the paper delves into how anime influences adolescent emotional expression, self-identity, creativity development, and social relationships. At the same time, it also analyzes the negative impacts that anime may bring, such as violence, pornography, social isolation, with factors including the characteristics of anime content, individual characteristics of adolescents, and family environment. Building upon this, the paper puts forward the responsibilities and strategies for parents, educators, government, and adolescents themselves in management and guidance. Finally, by comprehensively evaluating the impact of anime on adolescent mental health, future research directions and policy recommendations are discussed, providing theoretical support and practical guidance for promoting healthy adolescent development.

Application of an egocentric social network approach to examine changes in social connections following treatment for anxiety and depression: A novel measurement tool for clinical trials research?

The epidemic of loneliness and social isolation has been recognized as a public health crisis warranting the same prioritization as other public health issues today, such as obesity, substance use disorders, and tobacco use. Social disconnection is particularly prevalent and disabling among individuals with anxiety and depression, yet it is inadequately evaluated and addressed in most clinical psychology treatment research. Studies generally employ global measures of perceived connectedness, loneliness, or relationship satisfaction, limiting understanding about elements of one's social network that may change with treatment. This study examined changes in the degree (number of people nominated) and quality of one's social network from pre-to post-treatment using an egocentric social network approach in 59 adults (mean age = 30.8 years, range = 18 to 54) with clinically elevated anxiety or depression who were randomized to a cognitive and behavioral positive valence treatment versus waitlist. Participants (egos) named people in their lives (alters) with whom they discussed important issues or spent free time. For each alter, participants rated how close they felt, how close they thought the alter felt to them, and how frequently they communicated. Linear regressions, which included treatment group as a predictor, revealed no group differences in changes in network degree, perceived alter feelings of closeness, or communication frequency, despite prior findings from this sample indicating larger increases in perceived global connectedness in the treatment group. Unexpectedly, the control group reported a greater increase in perceived closeness to alters. Post-hoc analyses revealed this was explained by the treatment group identifying more distal social ties (e.g., extended family, colleagues, roommates) as alters following treatment – an outcome positively associated with global improvements in connectedness. This proof-of-concept study suggests egocentric social network surveys may provide unique information on treatment-related changes in social functioning. Suggestions are provided for adaptations to facilitate application of social network surveys to mental health treatment research.

The role of social support among caregivers of people with cancer from Chinese and Arabic communities: a qualitative study

PurposeCancer caregivers from culturally and linguistically diverse (CALD) communities have reported significant unmet emotional support needs. This study aimed explore the role of social support to manage emotional wellbeing among cancer caregivers from Arabic and Chinese communities in Australia.MethodsSemi-structured interviews were conducted with Chinese (n = 12) and Arabic (n = 12) speaking cancer caregivers. Participants’ mean age was 40.6 years; majority were female (83%) and providing care to a parent (41.67%).ResultsUsing thematic analysis to analyse interview data, five overarching themes emerged describing caregivers’ perspectives on social support. Themes were related to the following: (1) receiving emotional support from social networks, (2) barriers to accessing emotional support from social networks, (3) isolation and loss of connection following the cancer diagnosis, (4) faith as a source of support, and (5) utility of support groups and caregiver advocates. Several caregivers relied on social networks for emotional support; however, caregivers identified key cultural and generational barriers to seeking support from their social networks which prevented caregivers from disclosing their emotions and caregiving situation. Caregivers also reported being isolated from their support system.ConclusionEmpirical testing of culturally appropriate strategies that improve social support seeking among caregivers from CALD communities is recommended.

The Influence of Social Dynamics on Biological Aging and the Health of Historically Marginalized Populations: A Biopsychosocial Model for Health Disparities.

Historically marginalized populations are susceptible to social isolation resulting from their unique social dynamics; thus, they incur a higher risk of developing chronic diseases across the course of life. Research has suggested that the cumulative effect of aging trajectories per se, across the lifespan, determines later-in-life disease risks. Emerging evidence has shown the biopsychosocial effects of social stress and social support on one's wellbeing in terms of inflammation. Built upon previous multidisciplinary findings, here, we provide an overarching model that explains how the social dynamics of marginalized populations shape their rate of biological aging through the inflammatory process. Under the framework of social stress and social support theories, this model aims to facilitate our understanding of the biopsychosocial impacts of social dynamics on the wellbeing of historically marginalized individuals, with a special emphasis on biological aging. We leverage this model to advance our mechanistic understanding of the health disparity observed in historically marginalized populations and inform future remediation strategies.

SARS-CoV-2 Pandemic in a Small-Sized Municipality in Ceará State, Brazil: Temporal and Spatial Evolution.

Data on the temporal and spatial evolution of SARS-CoV-2 and local control measures and their effects on morbidity and mortality patterns in rural Brazil are scarce. We analyzed the data from case notification systems, epidemiological investigation reports, and municipal decrees in Itapajé, a small municipality in Ceará State in northeast Brazil. For spatial and spatio-temporal analyses, cases and deaths were mapped. There were a total of 3020 cases of COVID-19, recorded between April 2020 and December 2021; 135 (4.5%) died. The cumulative incidence and mortality rates were 5650.3 cases and 252.6 deaths per 100,000 people, respectively. The index case of SARS-CoV-2 in Itapajé was diagnosed in March 2020. The first peak of cases and deaths occurred in May 2020. The second wave peaked in May 2021, with the highest number of deaths in March 2021. According to the spatial analysis, the highest density of cases and deaths occurred in the central urban areas. In these areas, there were also the clusters of highest risk according to the spatio-temporal analyses. The municipal government issued 69 decrees on restriction measures, surveillance, and the maintenance of social isolation as a response to the pandemic. The spread of the SARS-CoV-2 pandemic in Itapajé mirrored the dynamics in large metropolitan regions, going from central neighborhoods of low socio-economic status to the wealthier peripheries.

The Purpose of Internet Use and Face-To-Face Communication With Friends and Acquaintances Among Older Adults: A JAGES Longitudinal Study.

Internet use influences social interactions in society. However, there is no consensus on whether and what kind of Internet use increases face-to-face communication (FFC). This study investigated the mode of Internet use that increases FFC among older adults after three years. Participants were 8734 adults aged 65 or older who responded to the Japan Gerontological Evaluation Study (JAGES) surveys in 2016 and 2019. The exposures were the purposes of Internet use in 2016. The outcome was the frequency of FFC with friends or acquaintances in 2019. The confounders included 13 demographic, socioeconomic, and psychological variables. We performed modified Poisson regression analyses and found that Internet use for communication in 2016 increased FFC in 2019, especially for low-frequency FFC in 2016. Internet-based non-FFC may help promote FFC and prevent social isolation among older adults who are less likely to interact with others.

The Benefits of Technology for Engaging Aging Adults: Findings from the PRISM 2.0 Trial

Abstract Background and Objectives Technology has potential for providing support for aging adults. This study evaluated the Personal Reminder Information and Social Management: 2.0 (PRISM 2.0) software, in terms of enhancing social engagement and quality of life, and decreasing loneliness among older adults. Research Design and Methods The randomized field trial conducted in diverse living contexts (rural locations, senior housing, and assisted living communities [ALC]). Two hundred and forty-five adults, aged 64 to 99 yrs., were randomly assigned to the PRISM 2.0 (integrated software system designed for aging through an iterative design process) or a Standard Tablet (without PRISM) Control condition, where participants received the same amount of contact and training as those in the PRISM 2.0 condition. Primary outcomes included measures of loneliness, social support, social connectedness, and quality of life. Secondary outcomes included measures of social isolation, mobile device proficiency, and technology readiness. Data were collected at baseline, and 6-and 9-months post randomization. This paper focuses on the 6-month outcomes due to COVID-19 related data challenges at 9 months. Results Contrary to our hypothesis, participants in rural locations and senior housing in both conditions reported less loneliness and social isolation, and greater social support and quality of life at 6 months, and an increase in mobile device proficiency. Participants in the ALCs in both conditions also evidenced an increase in mobile device proficiency. Improvements in quality of life and health-related quality of life were associated with decreases in loneliness. Discussion and Implications This study provides compelling evidence about the benefits of technology to older adults in terms of enhancing social outcomes and quality of life. However, the findings also underscore that for technology applications to be successful they need to be adapted to the abilities and needs of the user group and instructional support needs to be provided.

Verses Through Thorns: An Archetypal Interpretation of Trauma in Emily Dickinson's Poetry

Emily Dickinson, a renowned American poetess, authored nearly two thousand poems, embodying her legendary life through themes rich in emotion and complexity. Trauma, manifesting in various forms from her childhood to her reclusive later years, pervades Dickinson's secretive existence. Her poetry, marked by a profound personal touch, weaves the pain of loss, social isolation, unrequited love, physical suffering, and existential quandaries into metaphoric and symbolic language. Swiss psychoanalyst Carl Jung posited the existence of a collective unconscious in the human psyche, comprising universal symbols and motifs known as "archetypes", which subconsciously influence the poet's comprehension of trauma, thereby revealing themselves in her intricately profound verses. This paper explores the symbolic elements and manifestations of Dickinson's inner trauma through three classic archetypes— the Shadow, the Magician, and the Hero's Journey— examining how these archetypes' themes and symbols relate to her personal trauma experiences, thereby delving into the poet's psyche as she confronts trauma, seeking self-healing and personal growth.

Management of Fungating Oral Cancer: A Case Report

Abstract Fungating growths are most distressing causing substantial psychological distress for patients and families. Malodor associated with fungating growth causes social isolation, yet malodor management remains suboptimal. Management of fungating cancer growth of oral cavity is unique and difficult. This paper discusses the management of malodor and infection associated with fungating wound including definitive treatment of fungating growth of an oral cavity cancer patient.

Abusive use of Zolpidem as a Result of COVID-19 and Perspectives of Continuity of the Problem in the Post-Pandemic Period.

Zolpidem is a non-benzodiazepine hypnotic drug that works as a positive modulator of Gamma-Amino Butyric Acid-A (GABA-A) receptors, with high selectivity for α1 subunits. Given this selective binding, the drug has a strong hypnotic activity. Social isolation during the SARS-CoV-2 pandemic has contributed to increased rates of anxiety, depression, and insomnia. As a result, studies have pointed to a possible increase in the indiscriminate use of drugs with sedative effects, such as Zolpidem, during the pandemic. The aim of this work was to present prospective evidence that warns of the possibility of the abusive use of Zolpidem even after the pandemic. High rates of addiction to this drug have been reported around the world after the emergence of the coronavirus. Data from the National Survey on Drug Use and Health and from Medicaid support the continuing growth in prescription and indiscriminate use of Zolpidem during the pandemic and afterward. Therefore, there is enough evidence to support the indiscriminate use of this drug since the beginning of the pandemic. Rates of indiscriminate use of sedatives may continue to increase in the post-pandemic period, especially if strict control measures are not taken by health authorities.

Patterns of peripartum depression and anxiety during the pre-vaccine COVID-19 pandemic

BackgroundPregnant people are vulnerable to new or worsening mental health conditions. This study aims to describe prevalence and course of depression and anxiety symptoms in pregnancy during the pre-vaccine COVID-19 pandemic.MethodsThis is a prospective cohort study of pregnant individuals with known or suspected COVID-19. Participants completed Edinburgh Postnatal Depression Scale (EPDS) and Generalized-Anxiety Disorder-7 (GAD-7) questionnaires, screening tools for depression and anxiety, at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum. Prevalence of elevated depressive and anxiety symptoms at each visit was described. Univariable logistic regression analysis was used to determine the association between demographic and clinical factors and those with elevated depression or anxiety symptoms.Results317 participants were included. The prevalence of elevated antepartum depression symptoms was 14.6%, 10.3%, and 20.6% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. The rate of elevated anxiety symptoms was 15.1%, 10.0%, and 17.3% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. A prior history of depression and/or anxiety (p’s < 0.03), as well as higher EPDS and GAD-7 scores at enrollment (p’s < 0.04) associated with elevated depression and anxiety symptoms throughout pregnancy and the postpartum period. Quarantining during pregnancy was associated with elevated anxiety symptoms at 34weeks gestational age in univariate (P = 0.027) analyses. COVID-19 diagnosis and hospitalization were not associated with elevated depression or anxiety symptoms.ConclusionsElevated depression and anxiety symptoms were prevalent throughout pregnancy and the postpartum period, particularly in those with prior depression and/or anxiety and who quarantined. Strategies that target social isolation may mitigate potential adverse consequences for pregnant people, and continued vigilance in recognition of depression and anxiety in pregnancy should be considered.

Social isolation and mental well-being among Korean older adults: a focus on living arrangements.

The aging population in South Korea, characterized by an increasing number of older adults living alone, has raised concerns about its implications on mental health, specifically social isolation and loneliness that accompanies solitary living arrangements. This study explores the impact of living arrangements on the mental well-being of Korean older adults by focusing on the prevalence of depression and the role of social isolation in the context of evolving family structures and the COVID-19 pandemic. This cross-sectional study analyzed the responses of older adults aged 65 years and above (mean: 73.1, SD: 5.1) by using data from the Korea National Health and Nutrition Examination Survey conducted in 2018 and 2020. In total, responses from 3,365 older adults (1,653 in 2018 and 1,712 in 2020) were employed in this research. The participants' mental health status was assessed using the Patient Health Questionnaire-9, with living arrangements categorized by household size. A zero-inflated Poisson regression analysis was employed to investigate the relationship between living arrangements and depression severity, controlling for demographic, socioeconomic, and psychological factors. The study found that older adults living with others exhibited a lower depression severity than those living alone. Notably, the severity of depression decreased as the number of household members increased up to a certain threshold. Socio-economic factors, such as income level, marital status, and psychological stress were also identified as significant predictors of depression severity. However, the COVID-19 pandemic did not have a statistically significant impact on depression rates among older adults during the study period. Living arrangements play a critical role in the mental health of Korean older adults, with solitary living being associated with higher levels of depression. These findings underscore the importance of social support systems and suggest the need for policies and interventions that promote social connectivity and address the challenges of loneliness faced by them. Future research should explore longitudinal and qualitative studies to further understand causal relationships and develop targeted interventions to improve the mental well-being of the aging population.

P047 Mortality in patients with rheumatic disease over a three year period encompassing the COVID-19 pandemic: clinically extremely vulnerable status and short form 12 scores are predictive

Abstract Background/Aims In the United Kingdom (UK), to combat the coronavirus disease 2019 (COVID-19) pandemic, social distancing measures were implemented to varying degrees between March-2020 and December-2021. UK policy deemed patients with rheumatic disease (RD) at higher risk from COVID-19 and many were categorised as ‘clinically extremely vulnerable’ (CEV), these patients were required to follow more stringent social distancing measures. Social isolation and loneliness are implicated as predictors of mortality; the impact of these strict social distancing measures in patients with RD on mortality is unknown. In addition, Health related quality of life (HRQoL) measures provide useful insights into a patients physical and mental wellbeing. HRQoL is recognised as an important measure of health outcomes and there is limited evidence suggesting HRQoL measures such as the Health Assessment Questionnaire (HAQ) and the Short Form-36 questionnaire (SF-36) are associated with mortality in patients with rheumatoid arthritis. The predictive value of the SF-12 (a validated, shortened version of the SF-36) in RD patient’s mortality is unknown. In this UK-based, observational cohort study we evaluated the impact of stricter social distancing measures during the pandemic on 3-year mortality and assessed the utility of the SF-12 in predicting mortality in patients with RD. Methods We distributed a web-based survey via a linked mobile-phone SMS message, to all rheumatology patients, with a validated mobile number, under follow-up at the Royal Wolverhampton Trust, April-2020. We collected demographics, CEV status, and Short Form-12 mental (MCS) and physical health component scores (PCS) for health-related quality of life. Mortality was audited July-2023. Data were analysed using SPSS version 26 and R. Results There were 7,911 active follow up patients with linked mobile numbers. Survey responses were received from 1605 (20%); responders were female (69%), white (94%), CEV (47%), had a mean age of 61years, and most had autoimmune rheumatic disease (78%). Of the responders, 58 (4%) had died by July-2023 - compared to the alive group these patients had significantly worse MCS (p &amp;lt; 0.001) and PCS (p = 0.004) at baseline; significantly more in those that had died were CEV (p &amp;lt; 0.001), and older (p &amp;lt; 0.001), while gender, ethnicity, and diagnosis did not differ. Conclusion These data demonstrate in a large cohort of patients with RD over a 3-year period those patients considered CEV, advised to follow more stringent social isolation measures were at significantly greater risk of death. Further, baseline SF-12 scores for both mental and physical components were lower in patients that died over a 3-year period. These data potentially highlight the utility of the SF-12 and assessing social isolation and loneliness in patients with RD to predict mortality. In addition, our methods demonstrate the merits of communicating with patients through SMS-messaging and can be used in delivering important health-care communications in future. Disclosure N. Cox: None. J. Bateman: None.

Adaptation and Implementation of a Volunteer-Delivered, Telephone-Based, Social Support Program HOW-R-U? During the COVID-19 Pandemic: A Pragmatic Study.

Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020-December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people. This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness. The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity. HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations.

How do social networks, perception of social isolation, and loneliness affect depressive symptoms among Japanese adults?

This study aims to elucidate the complex relationship among social isolation, loneliness, and perception of social isolation and its influence on depressive symptoms by evaluating a hypothetical model. This understanding is essential for the formulation of effective intervention strategies. We conducted an online survey on Japanese adults (N = 3,315) and used the six-item Lubben Social Network Scale to assess the size of their social networks. We employed a single question to gauge their perception of social isolation. Loneliness was assessed using the three-item UCLA Loneliness Scale, and depressive symptoms were examined using the Patient Health Questionnaire-9. Structural equation modeling was employed to test the hypothesized model. The final model demonstrated satisfactory fit with data (χ2 (1) = 3.73; not significant; RMSEA = 0.03; CFI = 1.00; TLI = 1.00). The size of social network demonstrated a weak negative path to loneliness and depressive symptoms (β = -.13 to -.04). Notably, a strong positive association existed between perception of social isolation and loneliness (β = .66) and depressive symptoms (β = .27). Additionally, a significant positive relationship was found between loneliness and depressive symptoms (β = .40). Mediation analysis indicated that perception of social isolation and loneliness significantly intensified the relationships between social networks and depressive symptoms. Results indicate that interventions of psychological approaches, such as cognitive-behavioral therapy, are effective in reducing the perception of social isolation and loneliness, which may lead to the prevention of depressive symptoms. Future longitudinal studies are expected to refine and strengthen the proposed model.