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J Affect Disord. 2018 Apr 1;230:42-49. doi: 10.1016/j.jad.2018.01.003. Epub 2018 Jan 17.

Loneliness is closely associated with depression outcomes and suicidal ideation among military veterans in primary care.

Author information

1
VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), 3710 SW US Veterans Hospital Rd (R&D 66), Portland, OR 97239-2964, United States; Oregon Health & Science University, Department of Psychiatry, 3181 SW Sam Jackson Park Rd (Multnomah Pavilion, Room 2316), Portland, OR 97239-3098, United States; Oregon Health & Science University and Portland State University, School of Public Health, 506 SW Mill St, Suite 450 (OMPH-SCH), Portland, OR 97201-5404, United States. Electronic address: teoa@ohsu.edu.
2
VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), 3710 SW US Veterans Hospital Rd (R&D 66), Portland, OR 97239-2964, United States.
3
Oregon Health & Science University and Portland State University, School of Public Health, 506 SW Mill St, Suite 450 (OMPH-SCH), Portland, OR 97201-5404, United States; Oregon Health & Science University, Department of Internal Medicine, 3181 SW Sam Jackson Park Rd L475, Portland, OR 97239-3098, United States; Portland State University, School of Social Work, 1600 SW 4th Ave, Portland, OR 97201-5522, United States.
4
Portland State University, School of Community Health: Institute on Aging, P.O. Box 751 - IOA, Portland, OR 97207-0751, United States.
5
VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), 3710 SW US Veterans Hospital Rd (R&D 66), Portland, OR 97239-2964, United States; Oregon Health & Science University, Department of Internal Medicine, 3181 SW Sam Jackson Park Rd L475, Portland, OR 97239-3098, United States; Oregon Health & Science University, Department of Medical Informatics and Clinical Epidemiology, 3181 SW Sam Jackson Park Rd (5th Floor, Biomedical Information Communication Center), Portland, OR 97239-3098, United States.
6
VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care (CIVIC), 3710 SW US Veterans Hospital Rd (R&D 66), Portland, OR 97239-2964, United States; Oregon Health & Science University, Department of Psychiatry, 3181 SW Sam Jackson Park Rd (Multnomah Pavilion, Room 2316), Portland, OR 97239-3098, United States.

Abstract

BACKGROUND:

Although the substantial influence of social relationships on health is well-known, studies that concurrently examine the influence of varying dimensions of social connectedness on major depression are more limited. This study's aim was to determine to what degree several facets of social connectedness (number of confidants, social support, interpersonal conflict, social norms, and loneliness) are correlated with depression-related outcomes.

METHODS:

Participants were primary care patients (n = 301) with probable major depression at a Veterans Health Administration hospital and its satellite clinics. Social connectedness was primarily measured using multi-item instruments from the NIH Toolbox of Adult Social Relationship Scales. Primary outcomes were clinical symptoms (depression and suicidal ideation) and secondary outcomes were self-reported health-related behaviors (medication adherence, patient activation, and help-seeking intentions).

RESULTS:

In multivariate models adjusting for potential confounders and other facets of connectedness, loneliness was associated with higher levels of depression and suicidal ideation, as well as lower patient activation and help-seeking intentions. Social support and social norms about depression treatment were each associated with higher patient activation and help-seeking intentions. Social connectedness was not associated with medication adherence.

LIMITATIONS:

The limitations of this study are primarily related to its cross-sectional survey design and study population.

CONCLUSIONS:

Multiple aspects of social connectedness are associated with depression outcomes among military veterans with depression. Loneliness may represent the most important component of connectedness, as it is associated with depression severity, suicidality, and health-related behaviors.

KEYWORDS:

Social connectedness; Social network; Social support; Social tie; Veterans

PMID:
29407537
DOI:
10.1016/j.jad.2018.01.003
[Indexed for MEDLINE]

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