The bidirectional relationship between loneliness and common mental disorders in adults: findings from a longitudinal population-based cohort study
Limited longitudinal population-based research exists on the bidirectional association between loneliness and common mental disorders (CMDs). Using 3-year follow-up data, this study examined whether loneliness among adults increases the risk for onset and persistence of mild–moderate or severe CMD; and whether mild–moderate or severe CMD is a risk factor for onset and persistence of loneliness.
Data were used from the second (‘baseline’) and third (3-year follow-up) waves of the Netherlands Mental Health Survey and Incidence Study-2, a prospective study of a representative cohort of adults aged 18–64 years. Twelve-month CMDs and their severity were assessed with the Composite International Diagnostic Interview 3.0, and current loneliness using the De Jong Gierveld Loneliness Scale. Multivariate analyses were controlled for several potential confounders.
Loneliness predicted onset of severe CMD at follow-up in adults without CMDs at baseline, and increased risk for persistent severe CMD at follow-up in those with CMD at baseline. Conversely, severe CMD predicted onset of loneliness at follow-up in non-lonely adults at baseline, but was not associated with persistent loneliness at follow-up in lonely adults at baseline. Observed associations remained significant after controlling for perceived social support at baseline, except for the relationship between loneliness and persistent severe CMD. No longitudinal relationships were observed between loneliness and mild–moderate CMD.
Attention should be paid to loneliness, both in adults with and without CMD. Further research is needed to better understand the mechanisms underlying the observed associations between loneliness and CMDs to develop successful interventions.
KeywordsLoneliness Common mental disorder Adult general population Prospective cohort study
NEMESIS-2 is conducted by The Netherlands Institute of Mental Health and Addiction (Trimbos Institute) in Utrecht. Financial support has been received from the Ministry of Health, Welfare and Sport, with supplementary support from The Netherlands Organization for Health Research and Development (ZonMw) and the Genetic Risk and Outcome of Psychosis (GROUP) investigators.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
NEMESIS-2 was approved by the Medical Ethics Review Committee for Institutions on Mental Health Care. After having been informed about the study aims, respondents provided written informed consent at each wave.
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