Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende Patientenratgeber
Erweiterte Suche
Anmelden
nach oben
Social Psychiatry and Psychiatric Epidemiology
Erschienen in:

06.11.2019 | Original Paper

Social connectedness, depression symptoms, and health service utilization: a longitudinal study of Veterans Health Administration patients

verfasst von: Jason I. Chen, Elizabeth R. Hooker, Meike Niederhausen, Heather E. Marsh, Somnath Saha, Steven K. Dobscha, Alan R. Teo

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Our study explored whether aspects of veterans’ social connectedness (social support, interpersonal conflict, loneliness, social norms, number of confidants) are associated with change in their depression symptoms and health services utilization over 1 year.

Methods

We conducted a prospective, longitudinal study of 262 military veterans who obtained primary care and other services at a Veterans Health Administration (VHA) facility and screened positive for depression. Participants completed surveys at baseline and 12-month follow-up. We measured social connectedness variables using the NIH Toolbox Adult Social Relationship Scales. We used the Patient Health Questionnaire to assess depression symptoms and suicidal ideation and administrative medical record data for health services utilization. We calculated change scores to model outcomes over time using multivariable regressions.

Results

We found that higher levels of baseline loneliness were associated with decreased depression severity over 1 year (B = − 1.55, 95% CI [− 2.53, − .56], p < .01). We found a similar association for suicidal ideation. In contrast, higher baseline number of confidants was associated with increased depression (B = .55, 95% CI [.18, .92], p < .01). Higher levels of emotional support were associated with decreased mental health visits (B = − 3.88, 95% CI [− 6.80, − .96], p < .01). No significant associations were found between social connectedness variables and primary care visits.

Conclusions

Emotional support may play an important role in reducing mental health treatment utilization among VHA-using veterans. Additional investigation as to how and why loneliness and number of confidants might be paradoxically associated with depression symptoms remains necessary.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Allen J, Balfour R, Bell R, Marmot M (2014) Social determinants of mental health. Int Rev Psychiatry 26(4):392–407PubMedCrossRef
2.
3.
Santini ZI, Koyanagi A, Tyrovolas S, Mason C, Haro JM (2015) The association between social relationships and depression: a systematic review. J Affect Disord 175:53–65PubMedCrossRef
4.
Perlman D, Peplau LA (1982) Theoretical approaches to loneliness. Loneliness: a sourcebook of current theory, research and therapy. Wiley, Hoboken, NJ, pp 123–134
5.
Cacioppo JT, Hawkley LC, Thisted RA (2010) Perceived social isolation makes me sad: five year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago health, aging, and social relations study. Psychol Aging 25(2):453–463PubMedPubMedCentralCrossRef
6.
American Psychological Association (2010) Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study [press release]. American Psychological Association, USA
7.
Mojtabai R, Olfson M, Mechanic D (2002) Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psychiatry 59(1):77–84PubMedCrossRef
8.
Mojtabai R, Olfson M, Sampson NA et al (2011) Barriers to mental health treatment: results from the National Comorbidity Survey Replication (NCS-R). Psychol Med 41(8):1751–1761PubMedCrossRef
9.
Fröjd S, Marttunen M, Pelkonen M, von der Pahlen B, Kaltiala-Heino R (2007) Adult and peer involvement in help-seeking for depression in adolescent population. Soc Psychiatry Psychiatr Epidemiol 42(12):945–952PubMedCrossRef
10.
Spoont Michele R, Nelson David B, Murdoch Maureen et al (2014) Impact of treatment beliefs and social network encouragement on initiation of care by va service users with PTSD. Psychiatr Serv 65(5):654–662PubMedCrossRef
11.
Demers A (2011) When veterans return: the role of community in reintegration. J Loss Trauma 16(2):160–179CrossRef
12.
Teo AR, Marsh HE, Forsberg CW et al (2018) Loneliness is closely associated with depression outcomes and suicidal ideation among military veterans in primary care. J Affect Disord 230:42–49PubMedCrossRef
13.
Trivedi RB, Post EP, Sun H et al (2015) Prevalence, comorbidity, and prognosis of mental health among US veterans. Am J Public Health 105(12):2564–2569PubMedPubMedCentralCrossRef
14.
Office of Mental Health and Suicide Prevention (2016) Suicide among veterans and other Americans, 2001–2014. US Department of Veterans Affairs, Washington, DC
15.
16.
Greden JF, Valenstein M, Spinner J et al (2010) Buddy-to-Buddy, a citizen soldier peer support program to counteract stigma, PTSD, depression, and suicide. Ann N Y Acad Sci 1208(1):90–97PubMedCrossRef
17.
Carmichael CL, Reis HT, Duberstein PR (2015) In your 20s it’s quantity, in your 30s it’s quality: the prognostic value of social activity across 30 years of adulthood. Psychol Aging 30(1):95–105PubMedPubMedCentralCrossRef
18.
Wrzus C, Hänel M, Wagner J, Neyer FJ (2013) Social network changes and life events across the life span: a meta-analysis. Psychol Bull 139(1):53–80PubMedCrossRef
19.
Cyranowski JM, Zill N, Bode R et al (2013) Assessing social support, companionship, and distress: NIH toolbox adult social relationship scales. Health Psychol 32(3):293–301PubMedPubMedCentralCrossRef
20.
Burt RS (1984) Network items and the general social survey. Soc Netw 6(4):293–339CrossRef
21.
McMillan D, Gilbody S, Richards D (2010) Defining successful treatment outcome in depression using the PHQ-9: a comparison of methods. J Affect Disord 127(1):122–129PubMedCrossRef
22.
Ouimette P, Wade M, Prins A, Schohn M (2008) Identifying PTSD in primary care: comparison of the primary care-PTSD screen (PC-PTSD) and the general health questionnaire-12 (GHQ). J Anxiety Disord 22(2):337–343PubMedCrossRef
23.
Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR (2007) AUDIT-C as a brief screen for alcohol misuse in primary care. Alcoholism 31(7):1208–1217PubMedCrossRef
24.
Selim AJ, Fincke BG, Ren XS et al (2004) Comorbidity assessments based on patient report: results from the veterans health study. J Ambul Care Manag 27(3):281–295CrossRef
25.
Van Orden KA, Cukrowicz KC, Witte TK, Joiner TE Jr (2012) Thwarted belongingness and perceived burdensomeness: construct validity and psychometric properties of the interpersonal needs questionnaire. Psychol Assess 24(1):197–215PubMedCrossRef
26.
Possemato K, Wade M, Andersen J, Ouimette P (2010) The impact of PTSD, depression, and substance use disorders on disease burden and health care utilization among OEF/OIF veterans. Psychol Trauma 2(3):218–223CrossRef
27.
Markovic A, Bowker JC (2017) Friends also matter: examining friendship adjustment indices as moderators of anxious-withdrawal and trajectories of change in psychological maladjustment. Dev Psychol 53(8):1462–1473PubMedPubMedCentralCrossRef
28.
Zlotnick C, Kohn R, Keitner G, Della Grotta SA (2000) The relationship between quality of interpersonal relationships and major depressive disorder: findings from the national comorbidity survey. J Affect Disord 59(3):205–215PubMedCrossRef
29.
30.
Metadaten
Titel
Social connectedness, depression symptoms, and health service utilization: a longitudinal study of Veterans Health Administration patients
verfasst von
Jason I. Chen
Elizabeth R. Hooker
Meike Niederhausen
Heather E. Marsh
Somnath Saha
Steven K. Dobscha
Alan R. Teo
Publikationsdatum
06.11.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 5/2020
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-019-01785-9

Weitere Artikel der Ausgabe 5/2020

Incidence of major depression diagnoses in the Canadian Armed Forces: longitudinal analysis of clinical and health administrative data

  • Open Access
  • Original Paper

Maternal schizophrenia and adverse birth outcomes: what mediates the risk?

  • Original Paper

Compulsory admissions and preferences in decision-making in patients with psychotic and bipolar disorders

  • Original Paper

Maternal personality traits, antenatal depressive symptoms and the postpartum mother–infant relationship: a prospective observational study

  • Open Access
  • Original Paper

Maternal mood symptoms in pregnancy and postpartum depression: association with exclusive breastfeeding in a population-based birth cohort

  • Original Paper

Cannabis use in individuals at clinical high-risk for psychosis: a comprehensive review

  • Review

Neu im Fachgebiet Psychiatrie

Medikamente verändern wohl Nährstoffzusammensetzung der Muttermilch

Einige Medikamente wie selektive Serotonin-Wiederaufnahmehemmer können offenbar die Makronährstoffzusammensetzung der Muttermilch verändern. Das birgt möglicherweise gesundheitliche Risiken für manche gestillte Kinder.

Psychologische Interventionen können Depressionen oft verhindern

Gespräche, Telefonate, internetbasierte Verfahren: Mit solchen Methoden lässt sich der Beginn einer Depression bei gefährdeten Personen oft vermeiden. Sie funktionieren vor allem dann, wenn die Betroffenen deutliche Symptome aufweisen und noch keine Psychotherapie hatten.

Die beste Medizin gegen Altersdepression: Laufen, Lernen, Lachen, Lieben

Depressionen im Alter haben vielfältige Ursachen und verlaufen anders als bei jungen Menschen. Ohne einen multimodalen Ansatz kommt man oft nicht weit: Neben Medikamenten und Psychotherapien ist die physische, kognitive und soziale Aktivierung entscheidend.

Wir sozio-emotionalen Blobs

Entscheidungen sollten rational erfolgen – in der Politik wie im Leben. So wünschen wir uns das. Letztlich werden sie aber von Emotionen bestimmt. Wer das nicht versteht und anerkennt, wird kaum Wege aus Krisen finden. Die Neurowissenschaftlerin Maren Urner fordert daher eine „Reifeprüfung“ zur Krisenbewältigung.

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise