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Research article
Louis Achterbergh
Noordwest Ziekenhuisgroep
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5295-0073
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Psychiatry.
Background: Young people have a higher prevalence of loneliness than other age groups, and they are also at risk of depression. Quantitative studies describe a bidirectional association between loneliness and depression, but there is limited understanding of how these influence each other. Little is known about the experience of loneliness among young people with depression. Qualitative approaches may help understand the relationship between loneliness and depression among young people, and how to intervene to improve outcomes. We aimed to conduct a meta-synthesis to understand the complex inter-relationship between loneliness and depression among young depressed people by synthesising evidence from a systematic review of qualitative studies.
Methods: We conducted a meta-synthesis of qualitative studies capturing experiences of loneliness among young people with depression. We systematically searched six electronic databases for selected search terms, critically appraised eligible studies, and analysed the data from included studies using the approach of thematic synthesis. We used feedback from an inter-disciplinary research workshop to improve reflexivity.
Results: Our inclusion criteria identified fourteen studies. Our analysis identified four themes: (1) social withdrawal due to poor mental health, (2) non-disclosure of depression contributing to social distance, (3) the desire to connect, and (4) paradoxes of loneliness and depression. These themes illustrated a range of pathways between depression and loneliness, and a sense of how these might be mutually reinforcing. Our findings suggest that where depressed individuals engage in certain behaviours (withdrawing; not confiding) for a range of reasons, this can lead to feelings of loneliness, an awareness of which worsens their mood, thus perpetuating their depression.
Conclusions: Young people with depression experience loneliness as an insurmountable distance between themselves and others. Our findings identified non-disclosure of depression, and the debilitating nature of the depressive symptomatology, as factors perpetuating a vicious cycle of loneliness and depression. They suggest that approaches to tackling the problem might include helping young people communicate about their depression to trusted friends and educating their social networks in how to support them. The wider research literature suggests that cognitive interventions may have a role in shifting maladaptive cognitions about their social world.
Keywords
Loneliness, social isolation, depression, meta-synthesis, systematic review, qualitative research
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CURRENT STATUS: Published
Version 3
Posted 15 Aug, 2020
Published
On 24 Aug, 2020
No community comments so far
Submission checks complete
On 12 Aug, 2020
Editorial decision: Accept
On 10 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 20 Jul, 2020
Editor assigned
On 13 Jul, 2020
Submission checks complete
On 12 Jul, 2020
Editor invited
On 12 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 02 Jul, 2020
Review #2 received
Received 01 Jul, 2020
Review #4 received
Received 30 Jun, 2020
Review #3 received
Received 30 Jun, 2020
Review #1 received
Received 14 Jun, 2020
Reviewer #4 agreed
On 14 Jun, 2020
Reviewer #2 agreed
On 12 Jun, 2020
Reviewer #3 agreed
On 12 Jun, 2020
Reviewer #1 agreed
On 27 May, 2020
Reviewers invited
Invitations sent on 24 May, 2020
Submission checks complete
On 04 May, 2020
Editor assigned
On 03 May, 2020
Editor invited
On 02 May, 2020
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Subject Areas
Psychiatry
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This preprint is under consideration at BMC Psychiatry. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Louis Achterbergh
Noordwest Ziekenhuisgroep
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5295-0073
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 15 Aug, 2020
Published
On 24 Aug, 2020
No community comments so far
Submission checks complete
On 12 Aug, 2020
Editorial decision: Accept
On 10 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 20 Jul, 2020
Editor assigned
On 13 Jul, 2020
Submission checks complete
On 12 Jul, 2020
Editor invited
On 12 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 02 Jul, 2020
Review #2 received
Received 01 Jul, 2020
Review #4 received
Received 30 Jun, 2020
Review #3 received
Received 30 Jun, 2020
Review #1 received
Received 14 Jun, 2020
Reviewer #4 agreed
On 14 Jun, 2020
Reviewer #2 agreed
On 12 Jun, 2020
Reviewer #3 agreed
On 12 Jun, 2020
Reviewer #1 agreed
On 27 May, 2020
Reviewers invited
Invitations sent on 24 May, 2020
Submission checks complete
On 04 May, 2020
Editor assigned
On 03 May, 2020
Editor invited
On 02 May, 2020
Subject Areas
Psychiatry
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Psychiatry.
Background: Young people have a higher prevalence of loneliness than other age groups, and they are also at risk of depression. Quantitative studies describe a bidirectional association between loneliness and depression, but there is limited understanding of how these influence each other. Little is known about the experience of loneliness among young people with depression. Qualitative approaches may help understand the relationship between loneliness and depression among young people, and how to intervene to improve outcomes. We aimed to conduct a meta-synthesis to understand the complex inter-relationship between loneliness and depression among young depressed people by synthesising evidence from a systematic review of qualitative studies.
Methods: We conducted a meta-synthesis of qualitative studies capturing experiences of loneliness among young people with depression. We systematically searched six electronic databases for selected search terms, critically appraised eligible studies, and analysed the data from included studies using the approach of thematic synthesis. We used feedback from an inter-disciplinary research workshop to improve reflexivity.
Results: Our inclusion criteria identified fourteen studies. Our analysis identified four themes: (1) social withdrawal due to poor mental health, (2) non-disclosure of depression contributing to social distance, (3) the desire to connect, and (4) paradoxes of loneliness and depression. These themes illustrated a range of pathways between depression and loneliness, and a sense of how these might be mutually reinforcing. Our findings suggest that where depressed individuals engage in certain behaviours (withdrawing; not confiding) for a range of reasons, this can lead to feelings of loneliness, an awareness of which worsens their mood, thus perpetuating their depression.
Conclusions: Young people with depression experience loneliness as an insurmountable distance between themselves and others. Our findings identified non-disclosure of depression, and the debilitating nature of the depressive symptomatology, as factors perpetuating a vicious cycle of loneliness and depression. They suggest that approaches to tackling the problem might include helping young people communicate about their depression to trusted friends and educating their social networks in how to support them. The wider research literature suggests that cognitive interventions may have a role in shifting maladaptive cognitions about their social world.
Figure 1
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