COVID-19 and loneliness: A rapid systematic review (original) (raw)
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Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis
American Psychologist
The COVID-19 pandemic and measures aimed at its mitigation, such as physical distancing, have been discussed as risk factors for loneliness, which increases the risk of premature mortality and mental and physical health conditions. To ascertain whether loneliness has increased since the start of the pandemic, this study aimed to narratively and statistically synthesize relevant high-quality primary studies. This systematic review with meta-analysis was registered at PROSPERO (ID CRD42021246771). Searched databases were PubMed, PsycINFO, Cochrane Library/Central Register of Controlled Trials/EMBASE/CINAHL, Web of Science, the WHO COVID-19 Database, supplemented by Google Scholar and citation searching (cutoff date of the systematic search 05/12/2021). Summary data from prospective research including loneliness assessments before and during the pandemic were extracted. Of 6,850 retrieved records, 34 studies (23 longitudinal, 9 pseudolongitudinal, 2 reporting both designs) on 215,026 participants were included. Risk of bias (RoB) was estimated using the ROBINS-I tool. Standardized mean differences (SMD, Hedges' g) for continuous loneliness values and logOR for loneliness prevalence rates were calculated as pooled effect size estimators in random-effects meta-analyses. Pooling studies with longitudinal designs only (overall N=45,734), loneliness scores (19 studies, SMD=0.27 [95% confidence interval=0.14-0.40], Z=4.02, p<.001, I 2 =98%) and prevalence rates (8 studies, logOR=0.33 [0.04-0.62], Z=2.25, p=.02, I 2 =96%) increased relative to pre-pandemic times with small effect sizes. Results were robust with respect to studies' overall RoB, pseudo-longitudinal designs, timing of pre-pandemic assessments, and clinical populations. The heterogeneity of effects indicates a need to further investigate risk and protective factors as the pandemic progresses to inform targeted interventions.
Loneliness in the time of COVID-19: an alarming rise
The Lancet, 2023
It has been 3 years since WHO declared COVID-19 a pandemic. Globally, WHO reports 764 474 387 confirmed cases of COVID-19 and more than 6·9 million deaths at the time of writing this letter. The pandemic has brought about a plethora of health challenges, both physical and mental. Among these challenges, the sense of isolation and loneliness experienced by many people is particularly noteworthy. Consider a scenario where a person was away from home for work purposes but became stranded due to the pandemic. Unfortunately, during this period, the person’s mother passed away due to COVID-19. Regrettably, pandemicrelated travel restrictions prevented the individual from returning home to pay their last respects to their deceased mother. The person had no one to confide in personally. Months later, when the restrictions eased, the person returned to work but struggled to connect with their colleagues and chose to isolate themself from others. The experience left the person feeling lonely and isolated. The emotional toll of this traumatic event is unimaginable.1 This person is not the only one who feels the weight of loneliness, as many adults have been hit hard by this feeling during the COVID-19 pandemic.2 Unfortunately, these feelings are likely to continue and experts are concerned about the potential for loneliness to become a chronic issue. If left unaddressed, chronic loneliness can lead to various severe mental and physical health conditions.3 It is crucial for the medical community to recognise the impact of loneliness on individuals and take steps to address it. Loneliness is a painful, subjective experience characterised by a feeling of insufficient or unsatisfactory desired social connections. Loneliness can result in unhealthy behaviours, such as poor sleeping patterns, lack of exercise, and unhealthy dietary habits, which can contribute to an increased risk of premature mortality by 26% if not appropriately dealt with.4 Moreover, loneliness is believed to be associated with the adverse effects of chronic stress on the body, including inflammation, weakened immune function, and an elevated risk of cardiovascular disease.4 Health-care providers can incorporate screening for social isolation and loneliness into routine assessments and develop care plans that address these issues to avoid any further mental health-related concerns due to any novel illnesses.
International Journal of Environmental Research and Public Health, 2021
COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local “social distancing” policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3474 individuals from the USA, the UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive.
Loneliness during COVID-19: Development and influencing factors
PLOS ONE
In early pandemic waves, when vaccination against COVID-19 was not yet an option, distancing and reduced social contact were the most effective measures to slow down the pandemic. Changes in frequency and forms of social contact have reduced the spread of the COVID-19 virus and thus saved lives, yet there is increasing evidence for negative side effects such as mental health issues. In the present study, we investigate the development of loneliness and its predictors to examine the role of changes in social networks due to social distancing and other COVID-19-related life changes. A total of 737 participants (age range = 18–81 years) completed an online survey in three waves during the last quarter of 2020 at one-month intervals. Latent growth and multilevel modeling revealed that emotional loneliness increased over time, while social loneliness remained stable. Moreover, socially lonely individuals were likely to also develop emotional loneliness over time. Increased social distanc...
Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study
International Journal of Environmental Research and Public Health
The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during COVID-19 with 6% retrospectively reporting severe loneliness prior to the pandemic. A fifth were defined as isolated based on their usual connections, with 13% reporting a substantial increase in isolation during COVID-19. Personal finances and mental health were overarching and consistently cross-cutting pre...
Loneliness at the age of COVID-19
Journal of Medical Ethics
Loneliness has been a major concern for philosophers, poets and psychologists for centuries. In the past several decades, it has concerned clinicians and public health practitioners as well. The research on loneliness is urgent for several reasons. First, loneliness has been and still is extremely ubiquitous, potentially affecting people across multiple demographics and geographical areas. Second, it is philosophically intriguing, and its analysis delves into different branches of philosophy including phenomenology, existentialism, philosophy of mind, etc. Third, empirical research has shown that loneliness is a significant health risk factor. Loneliness may thus be defined as a (negative) social determinant of health.Having that said, COVID-19 has demonstrated how little we as members of humanity have been prepared to face the loneliness resulting from the global response to the virus. As people worldwide are literally dying from loneliness, we still do not know what makes one feel...
Behaviour Change
ObjectiveThe COVID-19 pandemic dramatically altered social determinants of health including work, education, social connections, movement, and perceived control; and loneliness was commonly experienced. This longitudinal study examined how social determinants at the personal (micro), community (meso), and societal (macro) levels predicted loneliness during the pandemic.MethodsParticipants were 2056 Australian adults surveyed up to three times over 18 months in 2020 and 2021. Multi-level mixed-effect regressions were conducted predicting loneliness from social determinants at baseline and two follow-ups.ResultsLoneliness was associated with numerous micro determinants: male gender, lifetime diagnosis of a mental health disorder, experience of recent stressful event(s), low income, living alone or couples with children, living in housing with low natural light, noise, and major building defects. Lower resilience and perceived control over health and life were also associated with grea...
Research in psychotherapy, 2021
Loneliness may be a consequence of social distancing, a measure imposed by several governments to try to reduce the contagion of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2). Despite being necessary, this measure may have thus caused a rise in mental health issues, leading to higher psychological distress and symptomatology. Thus, it is also important to explore how loneliness relates to the regulation of psychological needs. This study aims to explore the relationships between loneliness, symptomatology, and the regulation of psychological needs. 142 individuals (M age=32.7, SD=10.9), answered self-report questionnaires in a cross-sectional design. Results show that loneliness is positively correlated with symptomatology and difficulties in the regulation of psychological needs, with these relationships being mediated by psychological distress and psychological well-being. We discuss our results with a focus on loneliness and related psychopathological symptomatology, as they seem to be core factors in the regulation of psychological needs.
2020
Background: The mitigation strategies employed against the COVID-19 pandemic have severe mental health consequences. In particular, as a result of the social distancing protocols, loneliness is likely to increase. The aim of the present study was to investigate (a) the levels of loneliness in the Norwegian population during the strict social distancing non-pharmacological interventions (NPIs) implemented against the pandemic, (b) the risk and resilience factors for loneliness and (c) the associations between loneliness and psychopathology symptoms. Methods: A survey was disseminated online to the adult Norwegian population when strict social distancing measures had been implemented for two weeks. The resulting sample of 10084 respondents was proportionally biased in terms of gender and educational level and sensitivity analyses were conducted. The levels of loneliness were compared to those found in other studies during non-pandemic circumstances, loneliness levels were compared acr...
Loneliness during the COVID-19 pandemic
Aging & Mental Health, 2021
Responses to the COVID-19 pandemic in terms of physical distancing risk collateral damage such as increased loneliness. Older adults have been identified as being at higher risk of poor outcomes if infected and in many countries have been subjected to greater restrictions on physical contacts with others. Most research so far points towards an increase in loneliness during the pandemic. However, there has been a lack of prospective studies based on representative samples of older adults, with the oldest old, older adults with low or no Internet usage, and those in poor health currently underrepresented. Despite the significance of cultural norms for individuals' standards for social relations and, thus, the experience of loneliness, there has been a lack of comparative research on loneliness in older adults during the pandemic. Reviews have found little evidence for what interventions and what elements of interventions are effective in reducing loneliness. There is potential for social relations to be maintained via technology-based solutions, although there is a risk of excluding older adults with limited resources who are both least likely to use technology and most vulnerable to loneliness. Furthermore, remote social contacts cannot fully compensate for the loss of physical contacts. Where stay-at-home orders are not imposed, supporting neighbourliness and the community use of accessible open spaces are other options. Finally, policy responses to the pandemic need to be more nuanced and non-ageist in order to avoid unnecessary increases in loneliness in older adults.