CoChat
Sign Up
Cited by 1,223Health disparities and outcomesCOVID-19 and Mental HealthMental Health Treatment and Access

Loneliness in the general population: prevalence, determinants and relations to mental health

Open access
Beutel, Manfred E., Klein, Eva M., Brähler, Elmar, Reiner, Iris, Jünger, Claus, Michal, Matthias, Wiltink, Jörg, Wild, Philipp S. +3 more·2017·BMC Psychiatry
DOI 10.1186/s12888-017-1262-xPMC PMC5359916
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: While loneliness has been regarded as a risk to mental and physical health, there is a lack of current community data covering a broad age range. This study used a large and representative German adult sample to investigate loneliness. METHODS: Baseline data of the Gutenberg Health Study (GHS) collected between April 2007 and April 2012 (N = 15,010; 35-74 years), were analyzed. Recruitment for the community-based, prospective, observational cohort study was performed in equal strata for gender, residence and age decades. Measures were provided by self-report and interview. Loneliness was used as a predictor for distress (depression, generalized anxiety, and suicidal ideation) in logistic regression analyses adjusting for sociodemographic variables and mental distress. RESULTS: A total of 10.5% of participants reported some degree of loneliness (4.9% slight, 3.9% moderate and 1.7% severely distressed by loneliness). Loneliness declined across age groups. Loneliness was stronger in women, in participants without a partner, and in those living alone and without children. Controlling for demographic variables and other sources of distress loneliness was associated with depression (OR = 1.91), generalized anxiety (OR = 1.21) and suicidal ideation (OR = 1.35). Lonely participants also smoked more and visited physicians more frequently. CONCLUSIONS: The findings support the view that loneliness poses a significant health problem for a sizeable part of the population with increased risks in terms of distress (depression, anxiety), suicidal ideation, health behavior and health care utilization.

AI snapshot

Written from the paper’s full text.

TL;DR

In a large German community sample aged 35–74, 10.5% reported some degree of loneliness, and loneliness was associated with depression, generalized anxiety, suicidal ideation, smoking, and greater health care use after adjustment. The authors conclude loneliness is a significant public health problem in this population.

Key findings

  • Among 15,010 participants, 10.5% reported some loneliness: 4.9% slight, 3.9% moderate, and 1.7% severely distressed by loneliness; loneliness declined across age groups.
  • Loneliness was more frequent in women, participants without a partner, those without children, and those living alone; SES declined with increasing loneliness.
  • Adjusting for sociodemographic variables and other distress, loneliness predicted depression (OR = 1.91, 95% CI 1.74–2.09), generalized anxiety (OR = 1.21, 95% CI 1.09–1.34), and suicidal ideation (abstract/discussion report OR = 1.35; Table 2 lists OR = 1.31, 95% CI 1.19–1.44).
  • Severe loneliness was associated with more smoking, physician visits (63% vs. 42% with no loneliness), inpatient treatment (21% vs. 13%), antidepressant use (24.8% vs. 4.5%), and anxiolytic use (3.3% vs. 0.8%).

Methods

  • Cross-sectional baseline data from the Gutenberg Health Study (GHS), collected April 2007–April 2012: population-based, prospective, observational single-center cohort in Mainz and Mainz-Bingen, Germany; N = 15,010, aged 35–74, mean age 54.9 ± 11.1, 49.4% female.
  • Recruitment was stratified in equal strata for gender, residence, and age decades; response rate was 60.3%, and 5.8% were excluded for insufficient German language or inability to participate.
  • Loneliness was assessed by a single item about being frequently alone/having few contacts and suffering from it, recoded into no, slight, moderate, and severe loneliness; associations with depression (PHQ-8 ≥ 10), generalized anxiety (GAD-2 ≥ 3), and suicidal ideation were tested in multiple generalized linear models with binomial distribution and log link, adjusted for sociodemographic variables and mental distress.

Limitations

  • The authors state the cross-sectional design does not permit causal conclusions; loneliness may contribute to distress and suicidality, but depression and anxiety may also lead to social withdrawal.
  • The authors state they did not directly assess the size and quality of social networks, so they cannot estimate the effect of social isolation, a confounding variable when investigating loneliness.
  • The authors state loneliness was measured with only a single item, and they recommend caution interpreting p-values because no adjustments for multiple testing were performed in this exploratory study; they also note that individuals under 35 years old were not studied. Evident from the text: the sample is from one German region and relies on self-report/interview measures, with a 60.3% response rate.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12888-017-1262-x

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 4 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In the Gutenberg Health Study sample aged 35-74, about 10-20% of participants living alone reported feeling lonely.

    “about 10-20% of the participants living alone indicated feeling lonely.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the Gutenberg Health Study sample aged 35-74, loneliness was more frequent in participants without children than in those with children.

    “Loneliness was stronger in women, in participants without a partner, and in those living alone and without children.”
    • Also stated in: § Results · plain
      “Loneliness was more frequent in women, in participants without a partner or without children.”
    • Also stated in: § Discussion · plain
      “Loneliness was more frequent in women, in participants without a partnership, without children and in those living alone.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the Gutenberg Health Study sample aged 35-74, among participants living alone aged 45-54 and 65-74, no significant gender differences in loneliness were observed.

    “In the age range of 45-54 years (14.2% vs. 15.4%) and 65-74 years (10.7% vs. 10.6%), no significant gender differences were observed when participant lived alone.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the Gutenberg Health Study sample aged 35-74, Type D personality increased considerably with the degree of loneliness.

    “Type D increased considerably with the degree of loneliness.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the Gutenberg Health Study sample aged 35-74, loneliness was more frequent in participants without a partner than in those with a partner.

    “Loneliness was stronger in women, in participants without a partner, and in those living alone and without children.”
    • Also stated in: § Results · plain
      “Loneliness was more frequent in women, in participants without a partner or without children.”
    • Also stated in: § Discussion · plain
      “Loneliness was more frequent in women, in participants without a partnership, without children and in those living alone.”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim. 8
  • May combine two claims. 8
  • Classified as probably not a substantial claim. 9

  • The quote only partly states this claim.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, loneliness was associated with more frequent physician visits in the past month.

    “Lonely participants also smoked more and visited physicians more frequently.”
    • Also stated in: § Results · plain
      “The majority of participants (63%) with a strong degree of loneliness had visited a physician (vs. 42% with no feelings of loneliness)”
    • Also stated in: § Discussion · plain
      “the majority of participants (63%) with a strong degree of loneliness had visited a physician (vs. 42% without loneliness)”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, higher loneliness was associated with lower average alcohol consumption.

    “The average alcohol consumption was negatively linked to loneliness.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, among severely lonely participants, more than half were depressed, over 40% reported anxiety and suicidal ideation, and 30% reported panic attacks in the past 4 weeks.

    “more than half of the loneliest participants were also depressed (vs. 5% in the group with feelings of loneliness), and over 40% in this group reported anxiety and suicidal ideation (which increased from 6% to 42%) and 30% panic attacks in the past 4 weeks.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, among participants living alone, the highest loneliness proportion was in women aged 35-44 (20.7%), whereas men tended to report heightened loneliness at ages 45-54 (15.4%).

    “Among those living alone, the highest proportion of loneliness was found in the youngest group of women in the range from 35 to 44 years (20.7%), whereas men tended to report heightened loneliness in the range from 45 to 54 years (15.4%).”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, loneliness was associated with increased intake of antidepressants and anxiolytics.

    “there were strong increases in the intake of anxiolytics and antidepressants among lonely participants.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, after adjusting for sociodemographic variables and other sources of distress, loneliness was associated with generalized anxiety (OR = 1.21).

    “generalized anxiety (OR = 1.21)”
    • Also stated in: § Results · plain
      “loneliness also positively predicted anxiety (OR = 1.21)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Non-response (response rate 60.3%) and exclusions (5.8%) did not substantially bias the prevalence and association estimates in the Gutenberg Health Study sample.

  • May combine two claims.

    Findingown data

    In the Gutenberg Health Study baseline sample aged 35-74, 10.5% of participants reported some degree of loneliness, comprising 4.9% slight, 3.9% moderate, and 1.7% severe loneliness.

    “A total of 10.5% of participants reported some degree of loneliness (4.9% slight, 3.9% moderate and 1.7% severely distressed by loneliness).”
    • Also stated in: § Results · plain
      “A total of 10.5% reported some degree of loneliness: 4.9% were slightly, 3.9% moderately and 1.7% severely distressed by feeling lonely.”
    • Also stated in: § Discussion · plain
      “we found that one in 10 (10.5%) participants reported some degree of loneliness.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Non-response (response rate 60.3%) and exclusions (5.8%) did not substantially bias the prevalence and association estimates in the Gutenberg Health Study sample.

  • The quote only partly states this claim.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, loneliness was associated with more inpatient treatments in the past year.

    “21% (vs. 13%) had had inpatient treatments.”
    • Also stated in: § Discussion · plain
      “21% had had inpatient treatments.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, after adjusting for sociodemographic variables and other sources of distress, loneliness was associated with depression (OR = 1.91).

    “loneliness was associated with depression (OR = 1.91)”
    • Also stated in: § Results · plain
      “Loneliness as one of the predictors of the first regression model almost doubled the likelihood of depression (OR = 1.91).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Non-response (response rate 60.3%) and exclusions (5.8%) did not substantially bias the prevalence and association estimates in the Gutenberg Health Study sample.

  • The quote only partly states this claim.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, loneliness was associated with higher smoking prevalence.

    “Lonely participants also smoked more and visited physicians more frequently.”
    • Also stated in: § Results · plain
      “The proportion of current smokers almost doubled with increasing loneliness.”
    • Also stated in: § Discussion · plain
      “Loneliness also contributed to smoking as an indicator for an unhealthy lifestyle”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    In the Gutenberg Health Study sample aged 35-74, after adjusting for sociodemographic variables and other sources of distress, loneliness was associated with suicidal ideation (OR = 1.35).

    “suicidal ideation (OR = 1.35)”
    • Also stated in: § Results · plain
      “Prediction of suicidal ideation by loneliness was also substantial (OR = 1.35)”
    • Also stated in: § Discussion · plain
      “for suicidal ideation and generalized anxiety, 1.35 and 1.21”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Non-response (response rate 60.3%) and exclusions (5.8%) did not substantially bias the prevalence and association estimates in the Gutenberg Health Study sample.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    The cross-sectional character of the study limits interpretation and does not permit causal conclusions.

    “Interpretation of our findings is limited by the cross-sectional character of our study which does not permit causal conclusions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    5.8% of the sample were excluded due to insufficient knowledge of German language or physical or mental inability to participate.

    “We excluded 5.8% of the sample due to insufficient knowledge of German language, physical or mental inability to participate.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    A PHQ-8 sum score of ≥10 for caseness achieves a sensitivity of 88% and a specificity of 88% for major depression.

    “According to [25], caseness was defined by a PHQ-8 sum score of ≥10, achieving a sensitivity of 88% and a specificity of 88% for major depression.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] Löwe B, Kroenke K, Herzog W, Gräfe K. Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9). J Affect Disord. 2004;81(1):61–6. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The study's strengths include a large sample size and the use of standardized self-report instruments to measure distress.

    “Strengths of this study reside in the large sample size and the use of standardized self-report instruments to measure distress.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The study did not directly assess the size and quality of social networks, so it cannot estimate the effect of social isolation, which is a confounding variable when investigating loneliness.

    “As we did not directly assess the size and quality of social networks, we cannot estimate the effect of social isolation in our study which is a confounding variable when investigating loneliness.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Recruitment was performed stratified in equal strata for gender, residence, and age decades.

    “Recruitment was performed stratified in equal strata for gender, residence and for age decades.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    No adjustments for multiple testing were performed because the study was exploratory.

    “No adjustments for multiple testing were performed, as this was an exploratory study.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The sample was drawn at random from the local registries of the city of Mainz and the adjacent district of Mainz-Bingen.

    “The sample was drawn at random from the local registries of the city of Mainz and the adjacent district of Mainz-Bingen.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The GAD-2 sum score assesses generalized anxiety with a sensitivity of 86% and a specificity of 83%.

    “According to [27], the sum score of the answers (0 = not at all, 1 = several days, 2 = over half the days, and 3 = nearly every day) assesses generalized anxiety with good sensitivity (86%) and specificity (83%).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Michal M, Wiltink J, Till Y, Wild PS, Münzel T, Blankenberg S, et al. Type-D personality and depersonalization are associated with suicidal ideation in the German general population aged 35–74: results from the Gutenberg Heart Study. J Affect Disord. 2010;125(1):227–33. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Loneliness poses a significant health problem for a sizeable part of the population, with increased risks in terms of distress (depression, anxiety), suicidal ideation, health behavior, and health care utilization.

    “The findings support the view that loneliness poses a significant health problem for a sizeable part of the population with increased risks in terms of distress (depression, anxiety), suicidal ideation, health behavior and health care utilization.”
    • Also stated in: § Conclusions · plain
      “Our findings support the view that loneliness poses a significant health problem for a sizeable part of the population with increased risks in terms of distress (depression, anxiety), suicidal ideation, health behavior and health care utilization.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Non-response (response rate 60.3%) and exclusions (5.8%) did not substantially bias the prevalence and association estimates in the Gutenberg Health Study sample.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The Gutenberg Health Study baseline response rate was 60.3%.

    “The response rate amounted to 60.3%.”
    Quote in the paperNot a substantial claim
22 of 22

  • The paper relies on this without support.

    Non-response (response rate 60.3%) and exclusions (5.8%) did not substantially bias the prevalence and association estimates in the Gutenberg Health Study sample.

    “The response rate amounted to 60.3%.”
    “We excluded 5.8% of the sample due to insufficient knowledge of German language, physical or mental inability to participate.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Associations between feelings of loneliness or lack of social support and anxiety, depression, suicidal ideation, and self-harming behaviours tend to be stronger among young females than among males.

    “associations between feelings of loneliness or lack of social support and anxiety, depression, suicidal ideation, and self-harming behaviours tend to be stronger among young females than among males (Beutel et al., 2017; Elbogen et al., 2021).”

    From Pathways of association between disordered eating in adolescence and mental health outcomes in young adulthood during the COVID-19 pandemic (2023) · cites this paper as Beutel et al., 2017

    The Results report associations of loneliness with depression, anxiety and suicidal ideation. The Discussion says younger women living without a partner reported loneliness more often than men, but does not show that loneliness–mental-health associations were stronger in young women. The paper did not directly assess social-network support, and the cited passages do not address self-harming behaviour. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The burden of mental illness in young adulthood often stems from factors experienced during adolescence, with loneliness being a significant, yet understudied factor.

    “The burden of mental illness in young adulthood often stems from factors experienced during adolescence, with loneliness being a significant, yet understudied factor [9, 10].”

    From The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study (2025) · cites this paper as [10]

    The Results and Discussion associate loneliness with depression, anxiety and suicidal ideation, and the Discussion calls for more research on its mental-health impact in people under 35. The paper does not establish that mental illness in young adulthood often stems from experiences during adolescence; it explicitly says its cross-sectional study cannot support causal conclusions. The indexed passages provide section labels but no page numbers. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Beutel et al. highlighted a strong association between loneliness and generalized anxiety and depression, especially among middle and late adulthood individuals.

    “Additionally, Beutel et al. [12] highlighted a strong association between loneliness and generalized anxiety and depression, especially among middle and late adulthood individuals.”

    From The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study (2025) · cites this paper as [12]

    The Results report associations of loneliness with depression (OR = 1.91) and generalized anxiety (OR = 1.21). They do not establish that these associations are especially strong in middle or late adulthood; the Discussion instead says younger age groups were more affected by loneliness. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Loneliness is associated with anxiety.

    “and is also associated with anxiety [12, 14].”

    From The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study (2025) · cites this paper as [12]

  • Loneliness represents a risk factor for depression.

    “Research shows that loneliness represents a risk factor for depression [12, 13]”

    From The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study (2025) · cites this paper as [12]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Regression link function conflicts with logistic-regression description

    Major

    The abstract describes logistic regression, which uses a logit link, while the methods specify a binomial model with a log link. These describe different models and effect measures, so they cannot both describe the reported analysis as written.

  • Suicidal-ideation estimate differs from Table 2

    Major

    The abstract and results report an estimate of 1.35 for loneliness and suicidal ideation, but Table 2 gives 1.31 for the same association.

  • Discussion reverses the gender difference at ages 55-64

    Minor

    The discussion says men aged 45-64 were more affected, whereas the results say women aged 55-64 living alone had substantially more loneliness than men.

  • Five-percent depression comparison names the wrong group

    Minor

    Table 1 gives a depression prevalence of 5.2% for participants with no loneliness; every group reporting loneliness has a higher prevalence. The results instead assign the approximately 5% figure to a group with feelings of loneliness.

4 of 4

Cites

Flagged first, then by citations

1 of the 38 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Beutel, M. E., Klein, E. M., Brähler, E., Reiner, I., Jünger, C., Michal, M., Wiltink, J., Wild, P. S., Münzel, T., Lackner, K. J., & Tibubos, A. N.
Affiliations
  • University Medical Center of the Johannes Gutenberg University Mainz (DE)
  • Johannes Gutenberg University Mainz (DE)
Corresponding author
Tibubos, Ana N.
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2017-03-20
Volume
17
Issue
1
Pages
97-97
ISSN
1471-244X (ISSN-L)
DOI
10.1186/s12888-017-1262-x
PMC
PMC5359916
OpenAlex
W2602706681
Cited by
1,223
References
38
Citations by year
2026: 99 · 2025: 173 · 2024: 182 · 2023: 179 · 2022: 201 · 2021: 196 · 2020: 118 · 2019: 47 · 2018: 21 · 2017: 4 · 2012: 1
FWCI
57.57
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Stiftung Rheinland-Pfalz für Innovation (AZ 961-386261/733)
  • Wissen schafft Zukunft
  • Center for Translational Vascular Biology (CTVB)
  • Boehringer Ingelheim and PHILIPS Medical Systems
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
loneliness, prevalence, mental health, depression, generalized anxiety disorder, suicidal ideation, living alone, singlehood, gender differences, age differences, smoking, health care utilization, Gutenberg Health Study
MeSH terms
Adult, Aged, Anxiety Disorders, Child, Cross-Sectional Studies, Depressive Disorder, Female, Germany, Humans, Loneliness, Male, Middle Aged, Population Surveillance, Risk Factors, Young Adult, Suicidal Ideation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review