Epidemiology of loneliness in a cohort of UK mental health community crisis service users
Open accessAbstract
PURPOSE: Loneliness is an important issue for mental health service users. However, it has not been a particularly prominent focus of recent mental health research. This paper aimed to explore the severity of loneliness among people leaving mental health community crisis services, and to identify factors associated with loneliness. METHODS: A total of 399 participants experiencing mental health crises recruited for a research trial from community crisis services were included in this cross-sectional study. They completed the eight-item measure of the University of California at Los Angeles Loneliness Scale and a set of instruments assessing socio-demographic, psychosocial, and psychiatric variables. RESULTS: Severity of loneliness was high among people leaving community crisis services. Longer years since first contact with mental health services (2-10 years, coefficient = 1.83, 95% CI 0.49-3.16; more than 10 years, coefficient = 1.91, 95% CI 0.46-3.36) and more severe affective symptoms (coefficient = 0.32, 95% CI 0.23-0.40) were associated with greater loneliness, whereas bigger social network size (coefficient = - 0.56, 95% CI - 0.76 to - 0.36) and greater social capital (coefficient = - 0.16, 95% CI - 0.31 to - 0.003) were associated with less severe loneliness. CONCLUSIONS: This paper supports a view that people experiencing mental health crises often report relatively severe loneliness, and that loneliness tends to become more severe during the course of illness. A greater awareness of loneliness among mental health professionals may be beneficial. Loneliness is a potential focus of the development of interventions to improve the lives and outcomes of people with significant mental health problems.
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Individuals experiencing pre-COVID mental distress are at greater risk of worsening symptoms, and those not previously unwell are at risk of developing mental ill health.
“Indeed, Wang et al. (2020) suggest that individuals experiencing pre‐Covid mental distress are at greater risk of worsening symptoms, and those not previously unwell are at risk of developing mental ill health.”
From Living through lockdown: A qualitative exploration of individuals' experiences in the UK. (2022) · cites this paper as Wang et al., 2020
The Results and Discussion address loneliness among UK mental health crisis-service users, and the Conclusions say loneliness may become more severe during illness. Searches for pre-COVID distress, pandemic-related symptom worsening, and new mental ill health in previously well people found no passage addressing the attributed claim. (LLM, conf=0.78)
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Cites
Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015) · Perspectives on Psychological Science · doi:10.1177/1745691614568352 · Cited by 6,043 · cited 1× · see citing works
“The high prevalence of loneliness is a serious problem for which we need to seek solutions considering its adverse physical and mental health consequences as well as its impact on resource use [47, 53].”
BackgroundThe Revised UCLA Loneliness Scale: concurrent and discriminant validity evidence
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.39.3.472 · Cited by 5,173 · cited 1× · see citing works
“For example, the most widely used loneliness measures were initially designed for the general population [61, 62].”
A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004) · Research on Aging · doi:10.1177/0164027504268574 · Cited by 4,781 · cited 5× · see citing works
“, the De Jong Gierveld 6-Item Loneliness Scale [57] and the UCLA 3-Item Loneliness Scale [58] which are short and possess robust psychometric properties.”
MethodInfluentialDepression: Causes and treatment
Beck, A. T. (1973) · Behavior Therapy · doi:10.1016/s0005-7894(73)80054-1 · Cited by 3,162 · cited 1× · see citing works
“People with depression also tend to have negative bias in thinking processes which leads to negative patterns of behaviour [50].”
BackgroundPerceived social isolation and cognition
Cacioppo, J. T., & Hawkley, L. C. (2009) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2009.06.005 · Cited by 2,144 · cited 2× · see citing works
“Masi and colleagues [48] described a regulatory loop model of loneliness, in which people who are lonely tend to have negative and biased social cognitions [49].”
BackgroundLubben, J., Blozik, E., Gillmann, G., Iliffe, S., von Renteln Kruse, W., Beck, J. C., & Stuck, A. E. (2006) · The Gerontologist · doi:10.1093/geront/46.4.503 · Cited by 2,123 · cited 3× · see citing works
“Third, the recruitment rate of 23.6% of identified eligible CI confidence interval, LSNS-6 Lubben Social Network Scale-6, HLSSC Health and Lifestyles Survey Social Capital Questionnaire, BPRS Brief Psychiatric Rating Scale, R2 adj = adjusted-R2 a Using multivariable linear regression analyses with loneliness score at…”
BackgroundMethodInfluentialStructures And Processes Of Social Support
House, J. S., Umberson, D., & Landis, K. R. (1988) · Annual Review of Sociology · doi:10.1146/annurev.so.14.080188.001453 · Cited by 2,041 · cited 1× · see citing works
“More importantly, the high prevalence of loneliness among service users is not only an individual but also a community and societal level problem, and macrosocial factors have been proposed as significant determinants of levels and content of social relationships [59].”
BackgroundA Meta-Analysis of Interventions to Reduce Loneliness
Masi, C. M., Chen, H.-Y., Hawkley, L. C., & Cacioppo, J. T. (2011) · Personality and Social Psychology Review · doi:10.1177/1088868310377394 · Cited by 1,995 · cited 2× · see citing works
“Masi and colleagues [48] described a regulatory loop model of loneliness, in which people who are lonely tend to have negative and biased social cognitions [49].”
BackgroundLoneliness: A Sourcebook of Current Theory, Research and Therapy.
Peplau, L. A., & Perlman, D. (1984) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2068915 · Cited by 1,937 · see citing works
Wang, J., Mann, F., Lloyd-Evans, B., Ma, R., & Johnson, S. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1736-5 · Cited by 1,494 · cited 2× · see citing works
“Greater loneliness was also reported to be associated with more severe depressive symptoms and poorer remission from depression in a systematic review [47].”
BackgroundSelf-citationA 6-Item Scale for Overall, Emotional, and Social Loneliness: Confirmatory Tests on Survey Data
Gierveld, J. D. J., & Tilburg, T. V. (2006) · Research on Aging · doi:10.1177/0164027506289723 · Cited by 1,467 · cited 5× · see citing works
“, the De Jong Gierveld 6-Item Loneliness Scale [57] and the UCLA 3-Item Loneliness Scale [58] which are short and possess robust psychometric properties.”
MethodInfluentialMissing Data: Five Practical Guidelines
Newman, D. A. (2014) · Organizational Research Methods · doi:10.1177/1094428114548590 · Cited by 1,411 · see citing works
The Development of a Rasch-Type Loneliness Scale
de Jong-Gierveld, J., & Kamphuls, F. (1985) · Applied Psychological Measurement · doi:10.1177/014662168500900307 · Cited by 1,291 · cited 1× · see citing works
“For example, the most widely used loneliness measures were initially designed for the general population [61, 62].”
A Short-Form Measure of Loneliness
Hays, R., & DiMatteo, M. R. (1987) · Journal of Personality Assessment · doi:10.1207/s15327752jpa5101_6 · Cited by 1,192 · cited 7× · see citing works
“The loneliness scale (ULS-8) was completed by all the respondents with 8 (2.0”
MethodInfluentialThe Prevalence of Loneliness Among Adults: A Case Study of the United Kingdom
Victor, C. R., & Yang, K. (2012) · The Journal of Psychology · doi:10.1080/00223980.2011.613875 · Cited by 746 · cited 1× · see citing works
“For people with depression, cross-sectional studies have found up to 40% of respondents feeling lonely all or most of the time [7], with an 11-fold increase in the odds of loneliness compared to adults with no mental disorder [8].”
BackgroundCohen-Mansfield, J., Hazan, H., Lerman, Y., & Shalom, V. (2016) · International Psychogeriatrics · doi:10.1017/s1041610215001532 · Cited by 691 · see citing works
VICTOR, C. R., SCAMBLER, S. J., BOWLING, A., & BOND, J. (2005) · Ageing and Society · doi:10.1017/s0144686x04003332 · Cited by 572 · cited 1× · see citing works
“This finding is consistent with the previous research in people with psychosis [9, 36, 40], although socio-demographic characteristics have been reported as linked to individual differences in loneliness in studies of general population [41, 42].”
Result(2018) · Encyclopedia of Social Network Analysis and Mining. 2nd Ed. · doi:10.1007/978-1-4939-7131-2_100671 · Cited by 452 · cited 1×
“This method was only used for ULS-8, BPRS subscales, and social capital, as this technique is appropriate to measures where all items are indicators of a specific concept or construct [31] and the items are parallel and approximately interchangeable [32].”
MethodLoneliness, friendship, and well-being in adults with autism spectrum disorders
Mazurek, M. O. (2014) · Autism · doi:10.1177/1362361312474121 · Cited by 401 · see citing works
Handling missing data in self-report measures.
Fox-Wasylyshyn, S. M., & El-Masri, M. (2005) · Research in Nursing and Health · doi:10.1002/nur.20100 · Cited by 389 · cited 2× · see citing works
“As the percentage of missing data was low, case mean substitution was used to replace the missing items with the subject’s mean score based on the items that were present for that subject [31].”
MethodRichard, A., Rohrmann, S., Vandeleur, C. L., Schmid, M., Barth, J., & Eichholzer, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0181442 · Cited by 350 · cited 1× · see citing works
“Evidence suggests that, in the general population, loneliness is associated with risk factors such as being a victim of domestic violence, lack of employment, not being married/ partnered, being a young or an older adult (compared with middle-aged individuals), and impaired self-reported health [6, 10].”
BackgroundSocial exclusion and mental health
Morgan, C., Burns, T., Fitzpatrick, R. M., Pinfold, V., & Priebe, S. (2007) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.106.034942 · Cited by 320 · cited 1× · see citing works
“They have an obvious effect on breaking an individual’s social ties through rejection, avoidance, and distancing from other people as well as discrimination in various areas of life [15, 16].”
BackgroundFeelings of loneliness among adults with mental disorder
Meltzer, H., Bebbington, P., Dennis, M. S., Jenkins, R., McManus, S., & Brugha, T. S. (2013) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0515-8 · Cited by 303 · cited 3× · see citing works
“For people with depression, cross-sectional studies have found up to 40% of respondents feeling lonely all or most of the time [7], with an 11-fold increase in the odds of loneliness compared to adults with no mental disorder [8].”
BackgroundEekhout, I., de Vet, H. C. W., Twisk, J. W. R., Brand, J. P. L., de Boer, M. R., & Heymans, M. W. (2014) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2013.09.009 · Cited by 302 · cited 1× · see citing works
“As case mean substitution was reported not to result in highly biased estimates only when less than 25% of item scores and less than 10% of cases are missing [33], 8 cases with more than 25% missing data on BPRS subscales or social capital measures were removed from the corresponding analyses.”
MethodLoneliness in Psychosis: A Meta-analytical Review
da Rocha, B. M., Rhodes, S., Vasilopoulou, E., & Hutton, P. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx036 · Cited by 286 · cited 1× · see citing works
“A recent systematic review found contradictory results about the relationship between loneliness and psychotic symptomatology [45], but findings from a meta-analysis reported a moderate association between loneliness and psychosis [46].”
BackgroundRelation between loneliness and depression: A structural equation analysis.
Weeks, D. G., Michela, J. L., Peplau, L. A., & Bragg, M. E. (1980) · Journal of Personality and Social Psychology · doi:10.1037/h0077709 · Cited by 257 · see citing works
Loneliness in psychosis: a systematic review
Lim, M. H., Gleeson, J., Álvarez‐Jiménez, M., & Penn, D. L. (2018) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-018-1482-5 · Cited by 235 · cited 1× · see citing works
“A recent systematic review found contradictory results about the relationship between loneliness and psychotic symptomatology [45], but findings from a meta-analysis reported a moderate association between loneliness and psychosis [46].”
BackgroundA biopsychosocial model as a guide for psychoeducation and treatment of depression
Schotte, C., Bossche, B. V. D., Doncker, D. D., Claes, S. J., & Cosyns, P. R. (2006) · Depression and Anxiety · doi:10.1002/da.20177 · Cited by 214 · cited 1× · see citing works
“The two factors together with biological processes, stressors, and interpersonal factors interact with one another and form a “negative downward loop” which pushes people further into depression [51].”
BackgroundBLUEPRINT FOR A SOCIAL PSYCHOLOGICAL THEORY OF LONELINESS
Peplau, L. A., & Perlman, D. (1979) · Elsevier eBooks · doi:10.1016/b978-0-08-022234-9.50020-0 · Cited by 212 · see citing works
A Randomized Trial of MBSR Versus Aerobic Exercise for Social Anxiety Disorder
Jazaieri, H., Goldin, P. R., Werner, K., Ziv, M., & Gross, J. J. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21863 · Cited by 210 · see citing works
Perese, E. F., & Wolf, M. (2005) · Issues in Mental Health Nursing · doi:10.1080/01612840590959425 · Cited by 189 · cited 1× · see citing works
“They have an obvious effect on breaking an individual’s social ties through rejection, avoidance, and distancing from other people as well as discrimination in various areas of life [15, 16].”
BackgroundWu, C., & Yao, G. (2008) · Personality and Individual Differences · doi:10.1016/j.paid.2008.02.003 · Cited by 169 · cited 1× · see citing works
“The scale was derived from the 20-item UCLA Loneliness Scale [20] by Hays and DiMatteo, and has a high level of validity and reliability [19, 21, 22].”
MethodLoneliness in psychotic disorders and its association with cognitive function and symptom profile
Badcock, J. C., Shah, S., Mackinnon, A., Stain, H. J., Galletly, C., Jablensky, A., & Morgan, V. A. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.10.027 · Cited by 168 · cited 3× · see citing works
“This finding is consistent with the previous research in people with psychosis [9, 36, 40], although socio-demographic characteristics have been reported as linked to individual differences in loneliness in studies of general population [41, 42].”
ResultHolvast, F., Burger, H., de Waal, M. M. W., van Marwijk, H. W. J., Comijs, H. C., & Verhaak, P. F. M. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.06.036 · Cited by 164 · see citing works
Promoting social capital to alleviate loneliness and improve health among older people in Spain
Coll‐Planas, L., Gómez, G. D. V., Carroza, P. B., Masat, T., Puig, T., & Monteserín, R. (2015) · Health & Social Care in the Community · doi:10.1111/hsc.12284 · Cited by 162 · cited 1× · see citing works
“The finding coheres with the existing studies showing that objective measures of social relations and perception of community-level structures or characteristics may affect the severity of loneliness [43, 44], although the direction of causality cannot be inferred.”
ResultDoğan, T., Çötok, N. A., & Tekin, E. G. (2011) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2011.04.053 · Cited by 156 · cited 1× · see citing works
“The scale was derived from the 20-item UCLA Loneliness Scale [20] by Hays and DiMatteo, and has a high level of validity and reliability [19, 21, 22].”
MethodA community survey of loneliness
Lauder, W., Sharkey, S., & Mummery, K. (2004) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2003.02968.x · Cited by 154 · cited 2× · see citing works
“Feelings of loneliness have been found to be more prevalent among people with mental health problems than in the general population [5, 6].”
BackgroundDeterminants of Loneliness among Older Adults in Canada
Gierveld, J. D. J., Keating, N. C., & Fast, J. E. (2015) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980815000070 · Cited by 150 · cited 1× · see citing works
“The finding coheres with the existing studies showing that objective measures of social relations and perception of community-level structures or characteristics may affect the severity of loneliness [43, 44], although the direction of causality cannot be inferred.”
ResultRoncone, R., Ventura, J., Impallomeni, M., Falloon, I., Morosini, P., Chiaravalle, E., & Casacchia, M. (1999) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1999.tb10850.x · Cited by 145 · see citing works
Johnson, S., Lamb, D., Marston, L., Osborn, D., Mason, O., Henderson, C., Ambler, G., Milton, A., Davidson, M., Christoforou, M., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31470-3 · Cited by 143 · cited 1× · see citing works
“The sample was recruited to participate in a trial of peer-delivered self-management for the CORE study (CRT Optimisation and RElapse prevention) which has already been reported [18]: this paper describes secondary analyses from the participant baseline data.”
MethodSelf-citationConceptualizations and measures of loneliness: a comparison of subscales
Cramer, K. M., & Barry, J. E. (1999) · Personality and Individual Differences · doi:10.1016/s0191-8869(98)00257-8 · Cited by 139 · cited 1× · see citing works
“To reduce response bias, the word ‘lonely’ never appears in the instrument [23].”
Backgroundvan Beljouw, I. M., Verhaak, P. F., Cuijpers, P., van Marwijk, H. W., & Penninx, B. W. (2010) · BMC Psychiatry · doi:10.1186/1471-244x-10-86 · Cited by 128 · cited 1× · see citing works
“It may be helpful for mental health professionals to screen for the severity of loneliness to identify people at risk, given that loneliness may influence mental health in both immediate and long term [8, 36, 55, 56].”
BackgroundQuality of Life, Loneliness, and Social Contact Among Long-Term Psychiatric Patients
Borge, L., Martinsen, E. W., Ruud, T., Watne, Ø., & Friis, S. (1999) · Psychiatric Services · doi:10.1176/ps.50.1.81 · Cited by 119 · cited 1× · see citing works
“Feelings of loneliness have been found to be more prevalent among people with mental health problems than in the general population [5, 6].”
BackgroundHealth Services and Delivery Research
Cullen, A. E., Achilla, E., Baker, J., Khondoker, M., Koeser, L., Moylan, L., Pettit, S., Quirk, A., Sethi, F., & Tulloch, A. (2017) · Health Services and Delivery Research · doi:10.3310/hs-dr · Cited by 111 · cited 1× · see citing works
“They may also not consider that it is their responsibility to help with this [54].”
BackgroundDazzi, F., Shafer, A., & Lauriola, M. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.07.001 · Cited by 96 · cited 7×
“As case mean substitution was reported not to result in highly biased estimates only when less than 25% of item scores and less than 10% of cases are missing [33], 8 cases with more than 25% missing data on BPRS subscales or social capital measures were removed from the corresponding analyses.”
MethodInfluentialBonin, M. F., McCreary, D., & Sadava, S. (2000) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.14.2.151 · Cited by 91 · cited 1× · see citing works
“27) [34] and Italian community-dwelling older adults of 65–89 years old from the”
BackgroundThe intensity and correlates of the feelings of loneliness in people with psychosis
Chrostek, A., Grygiel, P., Anczewska, M., Wciórka, J., & Świtaj, P. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.07.015 · Cited by 86 · cited 4× · see citing works
“This finding is consistent with the previous research in people with psychosis [9, 36, 40], although socio-demographic characteristics have been reported as linked to individual differences in loneliness in studies of general population [41, 42].”
BackgroundResultInfluentialSocial Networks and Negative Versus Positive Symptoms of Schizophrenia
Ng, H., Ca, P., Dl, C., & Rm, W. (1989) · Schizophrenia Bulletin · doi:10.1093/schbul/15.4.625 · Cited by 85 · see citing works
Dill, J. C., & Anderson, C. A. (2004) · American Psychological Association eBooks · doi:10.1037/10311-004 · Cited by 81 · cited 1× · see citing works
“Depression and loneliness appear to have a circular relationship, and people with depressive symptoms sometimes have an urge to avoid social contact and isolate themselves from others [13, 14].”
BackgroundThe campaign to end loneliness
Ferguson, L. (2011) · Working with Older People · doi:10.1108/13663661111144772 · Cited by 71 · see citing works
Is befriending by trained volunteers of value to people suffering from long-term mental illness?
Bradshaw, T., & Haddock, G. (1998) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.1998.00618.x · Cited by 60 · cited 1× · see citing works
“1 3 negatively influence people’s ability to establish and sustain relationships [11, 12].”
BackgroundPinfold, V., Sweet, D., Porter, I., Quinn, C., Byng, R., Griffiths, C., Billsborough, J., Enki, D. G., Chandler, R., Webber, M., et al. (2015) · Health Services and Delivery Research · doi:10.3310/hsdr03050 · Cited by 46 · see citing works
Loneliness and related factors among people with schizophrenia in Japan: a cross‐sectional study
Shioda, A., Tadaka, E., & Okochi, A. (2016) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12318 · Cited by 42 · see citing works
Flagged first, then by citations
13 of the 66 references couldn’t be matched to a known paper.
Research works printed but not linked: 5
- [4]Jopling K Sserwanja I Loneliness across the life course: a rapid review of the evidence 2016 UK Branch Calouste Gulbenkian Foundation
- [27]Bech P Larsen JK Andersen J The BPRS—pshchometric developments Psychopharmacol Bull 1988 24 1 118 121 3387515
- [28]Tarell JD Schulz SC Nursing assessment using the BRPS—a structured interview Psychopharmacol Bull 1988 24 1 105 111 3387513
- [35]Mulasso A, Roppolo M, Giannotta F, Rabaglietti E (2016) Associations of frailty and psychosocial factors with autonomy in daily activities: a cross-sectional study in Italian community-dwelling older adults. Clin Interv Aging. 10.2147/cia.s95162 PMC4714730 26811675 · DOI
- [61]Russell D Peplau LA Cutrona CE The revised Ucla Loneliness Scale—concurrent and discriminant validity evidence J Pers Soc Psychol 1980 39 3 472 480 10.1037/0022-3514.39.3.472 7431205 · DOI · Paper page
Cited by
Sorted by citations
Groarke, J. M., Berry, E., Graham-Wisener, L., McKenna-Plumley, P. E., McGlinchey, E., & Armour, C. (2020) · PLOS ONE · doi:10.1371/journal.pone.0239698 · Cited by 727 · see citing works
“On the other hand, close relationships and social capital have been associated with lower odds of being lonely [7,24].”
BackgroundWalker, S., Mackay, E., Barnett, P., Sheridan Rains, L., Leverton, M., Dalton-Locke, C., Trevillion, K., Lloyd-Evans, B., & Johnson, S. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30406-7 · Cited by 221 · see citing works
Self-citationLoneliness: contemporary insights into causes, correlates, and consequences
Lim, M. H., Holt‐Lunstad, J., & Badcock, J. C. (2020) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-020-01891-z · Cited by 100 · see citing works
Igbokwe, C. C., Ejeh, V. J., Agbaje, O. S., Umoke, P. I. C., Iweama, C. N., & Ozoemena, E. L. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01561-4 · Cited by 87 · see citing works
“The cut-off point was used in a previous study [35].”
BackgroundMethodMcComb, S. E., Goldberg, J. O., Flett, G. L., & Rose, A. L. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.563420 · Cited by 74 · see citing works
Burton, A., McKinlay, A. R., Aughterson, H., & Fancourt, D. E. (2021) · Journal of Mental Health · doi:10.1080/09638237.2021.1952953 · Cited by 94 · see citing works
“…by societal restrictions due to higher baseline risk of loneliness and social isolation (Holmes et al., 2020; Michalska da Rocha et al., 2018; Wang et al., 2020; Yao et al., 2020); and (iii) disruption to mental health service provision (Tromans et al., 2020) as well as reduced availability…”
BackgroundResultWang, J., Lloyd‐Evans, B., Marston, L., Mann, F., Ma, R., & Johnson, S. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02665-2 · Cited by 63 · see citing works
“Loneliness is a noteworthy example of a potentially important subjective social influence on mental health [2].”
BackgroundSelf-citationMa, R., Wang, J., Lloyd-Evans, B., Marston, L., & Johnson, S. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03430-9 · Cited by 30 · see citing works
Self-citationGender-specific association of loneliness and health care use in community-dwelling older adults
Boehlen, F. H., Heider, D., Schellberg, D., Hohls, J. K., Schöttker, B., Brenner, H., Friederich, H., König, H., & Wild, B. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04201-9 · Cited by 29 · see citing works
“Loneliness is suspected of leading to more contact with emergency departments, more frequent consultations with outpatient care providers, and an increased use of psychotropic drugs; it is also associated with longer hospital stays and increased rates of re-admission [2–4].”
BackgroundLoneliness Among Elderly Widows and Its Effect on Social and Mental Well-being
Abbas, N., haq, M. A. U., Ashiq, U., & Ubaid, S. (2020) · Global Social Welfare · doi:10.1007/s40609-020-00173-5 · Cited by 25 · see citing works
“…such as unhappiness and suicidal attempts, cardiac illness and hit, inflated stress extent, minimized recollection and study delinquent performance, bad management, intoxication and substance exploitation, the progression of Senile dementia, decreased improved mind operations (Wang et al. 2019).”
BackgroundLiving through lockdown: A qualitative exploration of individuals' experiences in the UK.
Taylor, C., Lafarge, C., Cahill, S., Milani, R., & Görzig, A. (2022) · Health & Social Care in the Community · doi:10.1111/hsc.13772 · Cited by 19 · see citing works
Suicide Risk and Living Alone With Depression or Anxiety
Moon, D. U., Kim, H., Jung, J., Han, K., & Jeon, H. J. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.1227 · Cited by 18 · see citing works
Parmar, M., Ma, R., Attygalle, S., Mueller, C., Stubbs, B., Stewart, R. J., & Perera, G. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-021-02079-9 · Cited by 24 · see citing works
“In cohorts such as community mental health service users diagnosed with SMI [12] or those in crisis [41], the prevalence of loneliness was reported at 71 and 31% respectively, thus higher than ours in comparison.”
ResultSelf-citationMorant, N., Davidson, M., Wackett, J., Lamb, D., Pinfold, V., Smith, D., Johnson, S., Lloyd-Evans, B., & Osborn, D. P. J. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03140-2 · Cited by 17 · see citing works
“High rates of loneliness are also reported among those leaving CRT care [14].”
BackgroundSelf-citationOkruszek, Ł., Jarkiewicz, M., Piejka, A., Chrustowicz, M., Krawczyk, M., Schudy, A., Harvey, P. D., Penn, D. L., Ludwig, K., Green, M. F., et al. (2023) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617723000206 · Cited by 18 · see citing works
Baiden, P., LaBrenz, C. A., & Findley, E. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100154 · Cited by 13 · see citing works
Hochard, K. D., Hulbert‐Williams, L., Ashcroft, S., & McLoughlin, S. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.05.001 · Cited by 17 · see citing works
Parmar, M., Ma, R., Attygalle, S., Herath, M. D., Mueller, C., Stubbs, B., Stewart, R. J., & Perera, G. (2024) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-024-02663-9 · Cited by 11 · see citing works
“…- pants were considered to have severe loneliness, Wang et al. (2020) found that a higher score of loneliness at baseline predicted poorer health-related quality of life four months later amongst a sample of people with mental disorders who received treatment from community crisis services [9 ].”
BackgroundSelf-citationPark, J., & Joshanloo, M. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.922201 · Cited by 12 · see citing works
“Loneliness is suggested to have an important impact mental health (Wang et al., 2020).”
BackgroundNewbronner, E., Walker, L. E., Wadman, R., Crosland, S., Johnston, G., Heron, P., Spanakis, P., Gilbody, S. M., & Peckham, E. J. (2022) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2022.2122135 · Cited by 6 · see citing works
“People with existing mental health conditions are more at risk of experiencing social isolation, loneliness and loss of routine (Heron et al., 2022; Murphy et al., 2021; Wang et al., 2020) because of the pandemic restrictions.”
BackgroundCardiovascular disease risk in people with severe mental disorders: an update and call for action
Rødevand, L. N., Tesli, M., & Andreassen, O. A. (2022) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000797 · Cited by 9 · see citing works
Loneliness in emerging adulthood: A qualitative study using cultural probes and in-depth interviews
Nielsen, B. K., Nielsen, L. A., & Lasgaard, M. (2024) · Current Research in Behavioral Sciences · doi:10.1016/j.crbeha.2024.100154 · Cited by 5 · see citing works
McOwat, K., Pereira, S. M. P., Nugawela, M. D., Ladhani, S. N., Newlands, F., Stephenson, T. J., Simmons, R., Semple, M. G., Segal, T. Y., Buszewicz, M., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0294165 · Cited by 5 · see citing works
Tzouvara, V., & Kupdere, P. (2022) · Social Sciences · doi:10.3390/socsci11090425 · Cited by 5 · see citing works
Housing and loneliness among individuals with serious mental illnesses
Nagata, S., Brusilovskiy, E., Townley, G., McCormick, B. P., Thomas, E. C., Snethen, G., & Salzer, M. S. (2022) · International Journal of Social Psychiatry · doi:10.1177/00207640221119636 · Cited by 7 · see citing works
“, 2018), depressive symptoms (Lim et al., 2018; Wang et al., 2020), and participation in community activities (Nagata et al.”
BackgroundDual Diagnosis Anonymous (DDA) and the Transition to Online Support During COVID-19
Milani, R. M., Keller, A., & Roush, S. (2020) · Journal of Concurrent Disorders · doi:10.54127/jtfj8349 · Cited by 2 · see citing works
“In the UK, utilization of Needle and Syringe Programs (NSP) has halved since the onset of the pandemic—indicating a further increase in needle sharing and re-use (Whitfield et al., 2020).”
Chandler, L., Li, Y., Agarwal, D., Antkiewicz, J., Chike-Michael, J., Giacco, D., Jilka, S., Mensah, D., Saunders, I., Toro, C. T., et al. (2026) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph23060739 · Cited by 1 · see citing works
“Although there is no standard cut-off score for the ULS-8, previous research has highlighted that a score of 24 could be a potential cut-off for considering severe loneliness [38].”
Exploring Latent Profiles of Psychopathology in a Sample of Lonely People Seeking Treatment
Käll, A., Shafran, R., & Andersson, G. (2021) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-021-09870-7 · Cited by 6 · see citing works
Zhang, C., Yuan, T., Cui, Y., Zheng, C., Qing, Y., Liu, K., Pan, L., Zhang, L., Su, Y., Ding, F., et al. (2026) · Social Indicators Research · doi:10.1007/s11205-026-03925-6
“The severity of emotional symptoms has a particularly strong impact on loneliness, which may be exacerbated when individuals lack social resources (Wang et al., 2020).”
Loneliness among Chinese Adults: Validating the ALONE Scale With Age-Related Vulnerability
Ma, Y.-G., Leung, P., Berg‐Weger, M., Cheung, M., Malmstrom, T. K., Ma, G., & Chen, X. (2026) · Research on Social Work Practice · doi:10.1177/10497315261463199
Bioethics and the Culture of Loneliness
Gosić, N., & Tomak, T. (2026) · Science, Art and Religion. · doi:10.5005/jp-journals-11005-0133
Panhwar, M., Memon, P., & Khan, A. (2026) · Research Journal of Psychology · doi:10.59075/rjs.v4i1.344
“Females are often socialized to place value in interpersonal relationships and emotional expressiveness, resulting in more opportunities and disposition to seek and receive support (Wang et al., 2020).”
InfluentialDuran, S., ÖZ, Y. C., & İncedere, A. (2026) · Perspectives In Psychiatric Care · doi:10.1155/ppc/2728156
An Online Survey of the Dietary Practices of Saudi Students in the UK: A Quantitative Study
Qurain, A. M. A., Alturki, F., Hall, J., Alzain, H. M., Mitchell, G., & Leavey, C. (2023) · Journal of Agri-Food Science and Technology · doi:10.12928/jafost.v4i1.7641
“The BBC’s Loneliness Experiment, the world’s largest loneliness study, was also criticized of self-selection bias as it collected data via online surveys that relied on self-selecting samples, which gave the notion that people who felt lonely were more likely to participate (Wang et al., 2019).”
BackgroundThe problem of loneliness among women
Rustamova, D. (2023) · Social'naja politika i social'noe partnerstvo (Social Policy and Social Partnership) · doi:10.33920/pol-01-2304-07
- Authors
- Wang, J., Lloyd-Evans, B., Marston, L., Ma, R., Mann, F., Solmi, F., & Johnson, S.
- Affiliations
- University College London (GB)
- St Pancras Hospital (GB)
- Corresponding author
- Johnson, Sonia
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2019-06-20
- Volume
- 55
- Issue
- 7
- Pages
- 811-822
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- PMC
- PMC7303089
- OpenAlex
- W2950719666
- Cited by
- 53
- References
- 66
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 3 · 2023: 7 · 2022: 17 · 2021: 10 · 2020: 7 · 2019: 1
- FWCI
- 8.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- National Institute for Health Research (RP-PG-0109-10078)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- loneliness, mental health crisis, social network size, social capital, affective symptoms, mental health service users
- MeSH terms
- Adult, Aged, Mental Disorders, Community Mental Health Services, Cross-Sectional Studies, Female, United Kingdom, Humans, Loneliness, Male, Mental Health, Middle Aged, Cohort Studies
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