Mental Well-being and Perception of Loneliness Among Men in Poland

doi:10.21203/rs.3.rs-4018102/v1

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Mental Well-being and Perception of Loneliness Among Men in Poland

https://doi.org/10.21203/rs.3.rs-4018102/v1

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Background: Mental well-being is defined as subjective well-being, characterized by an emotional and cognitive evaluation of one's life that leads to high life satisfaction and low levels of negative emotions. It is estimated that in Poland in 2017, 2.4% of men suffered from depression. Research findings confirm that individuals with a high sense of loneliness often face mental health issues. Loneliness is a predictor of the likelihood of depression, anxiety, and suicidal thoughts. The aim of this study was to assess the mental well-being in a group of men in Poland.

Methods: The study was conducted on a representative sample of 438 men who completed a survey through an online portal using the Computer-Assisted Web Interviewing (CAWI) technique. The Hospital Anxiety and Depression Scale (HADS-M) and the UCLA Loneliness Scale (R-UCLA) were used to assess mental well-being. The average age of the participating men was 45.61±15.64 years.

Results: On the HADS-M scale, participants scored an average of 13.91±9.35 points. Anxiety disorders were identified in 21.91% of the participants on the anxiety subscale, and depressive disorders in 12.55% on the depression subscale. On the loneliness scale, participants scored an average of 40.50±10.78 points. A moderately high and very high sense of loneliness was found in 21.00% and 2.30% of the participants, respectively.

Conclusions : In this study, one fifth of the participants experienced anxiety disorders, and every tenth man showed depressive disorders. Every fifth man experienced a moderately high sense of loneliness. The main predictor of depression symptoms and higher levels of loneliness was the poor financial situation of the participants and a lack of financial decisiveness.

Anxiety

depression

irritability

loneliness

and men

Depression, classified within mental disorders, is a significant cause of disability globally, impacting daily life and overall satisfaction. Symptoms like sadness, fatigue, lack of interest in previously enjoyable activities, sleep and appetite disorders, increased exhaustion, and concentration issues can lead to withdrawal from social, family, and work environments [1]. Due to societal norms, depression symptoms in men might present differently, such as through anger, aggression, panic attacks, and might be coped with using psychoactive substances, gambling, or workaholism [2,3]. Untreated depression can result in premature death due to physical health conditions and an increased suicide rate [4].

According to the World Health Organization (WHO), 5% of the global adult population suffers from depression [1]. While women are more frequently affected (6%) than men (4%) [5], men are 3–4 times more likely to commit suicide due to depression, despite attempting suicide less often than women. Men typically use more effective methods when it comes to taking their own lives [8].The higher suicide rate among men may be due to their choice of more lethal methods and a mentality valuing independence and reluctance to seek help, seen as a sign of weakness [9,10]. This contributes to many men with depression symptoms remaining undiagnosed.[6]

In Poland in 2017, depression affected 2.8% of the adult population, including 2.4% of men, which is lower than the average in European Union countries (over 4% for the general population, including 3.1% for men). The "Health at Glance: Europe 2018" report suggests that differences between countries could be due to access to healthcare, awareness levels, and social acceptance, significantly impacting the ability to seek help and the number of diagnosed depression cases [11]. It is estimated that over 75% of people in low- and middle-income countries do not receive treatment due to low investment in psychiatric care [5], lack of qualified staff, and social stigma, leading to shame and reduced help-seeking opportunities. Therefore, implementing preventive measures beyond the healthcare sector is crucial in identifying individuals at risk of mental health issues[12]. WHO experts call for expanding care for people with anxiety and depression by enhancing identification efforts. [12] The WHO report on the comprehensive mental health action plan for 2013–2030 emphasizes the need for attitude changes and actions to promote and protect mental health and provide care to those in need [13].

Mental health issues are complex, with anxiety disorders often co-occurring in individuals suffering from depression. It's estimated that about 85% of patients with depression symptoms also experience anxiety[ [14], and 90% of those with anxiety disorders suffer from depression [15]. Additionally, high levels of loneliness are frequently associated with mental health problems. Loneliness can predict the likelihood of depression, anxiety, suicidal thoughts, and dementia [16–21]. Depression symptoms present before the pandemic were the strongest predictor of loneliness in men during it [22]. Longitudinal studies in the general population have shown that social bonds protect adults from depressive symptoms and disorders [23].

Loneliness is described as an unpleasant sensation that arises when individuals perceive their social network as insufficient in both quality and quantity [24,25]. It is also defined as the discrepancy between actual and desired social relationships [26]. Many definitions of loneliness characterize it as an uncomfortable state of tension, which develops over time and is closely linked to health status. Many definitions of loneliness describe it as an unpleasant state of tension that develops gradually and is closely related to the state of health.

The prevalence of loneliness varies according to different studies. Data suggest that 1 in 3 adults experiences loneliness [27]. The highest prevalence is found in Eastern Europe, with rates varying by age group: 5.9–9.4% among young adults, 7.7–12.0% in middle-aged adults, and 18.7–24.2% among the elderly [28]. Lim et al.'s study found that 13% of participants experienced chronic loneliness, while 21% experienced a loneliness episode [29]. A study among men aged 60–64 years showed that 52% felt lonely [30]. During the COVID-19 pandemic, 6% of men aged 32–36 reported very high levels of loneliness, and 56% reported moderate to high levels [22].

Meta-analyses of evidence on gender differences in perceived loneliness throughout life indicate that average loneliness levels are similar for men and women [31]. However, some studies, like that by Baretto et al. [32], found men perceived greater loneliness than women. In contrast, Lim et al.'s study suggested men were 11% less likely than women to report loneliness [29]. The rates of loneliness among adult men are concerning, especially since over a third of the variance in suicidal thoughts and behaviors in this group is associated with loneliness [33].

Loneliness is associated with an approximately 30% increased risk of mortality from any cause, as well as stroke and heart disease [34–38]. Lonely individuals are more likely to engage in unhealthy eating behaviors, consume alcohol, and smoke tobacco [39,40]. Loneliness can also trigger symptoms of eating disorders [41]. Social bond deficits in individuals aged 50–95 are linked to accelerated aging, increased morbidity, disability, and mortality [42].

Our study is a screening investigation focused on identifying individuals with mental disorders such as depression and anxiety, and loneliness as a social determinant of mental health, posing a risk to mental well-being. Early detection of emotional disorders and the initiation of treatment are crucial from a public health perspective to prevent the exacerbation of mental health problems in society. The study's goal was to assess the mental well-being of a group of men in Poland.

Participants

The study was conducted in Poland in 2020 with a representative sample of 438 men using a two-stage random-quota method. Initially, residential locations were randomly selected, followed by a quota sample based on age and education level. Participants received a survey link upon consenting to participate, completing it via an online portal using the CAWI (Computer Assisted Web Interview) method. Conducted by Kantar Company, the sample structure mirrored the national population's demographic distribution in terms of gender, age, education, residential area size, and region, ensuring representativeness.

The analysis included 438 correctly completed questionnaires, with the average age of the male participants being 45.61 ± 15.64 years.

The study adhered to ethical principles, participation was voluntary and anonymous, and participants could withdraw at any time without reason. It received approval from the Bioethics Committee at the Medical University of Warsaw.

Instruments

Socio-demographic questionnair

The questionnaire collected sociodemographic data of the study group, including age, marital status, education, employment status, place of residence, income, household size, current living arrangements, as well as assessments of financial availability and financial situation. Participants were also asked about the presence of chronic diseases.

Hospital Anxiety and Depression Scale (HADS-M)

To assess anxiety and depression, the study used the Polish version of the HADS–M scale (Hospital Anxiety and Depression Scale) by Majkowicz et al.[43], a modified version of the HADS (The Hospital Anxiety and Depression Scale) scale by Zigmond and Snaith [44]. The HADS-M scale includes two additional statements assessing irritability levels, making a total of 16 questions, with scores ranging from 0 to 3 points per question. The maximum score for anxiety and depression (7 questions each) is 21 points, and for irritability (2 questions), it is 6 points. Scores are interpreted as follows: 0–7 indicate no disorders, 8–10 borderline, and 11–21 the presence of disorders.

In this study, the internal consistency of HADS-M was a = 0.94 for total score, a = 0.92 for anxiety subscale, a = 0.88 for depression subscale and a = 0.86 for irritability subscale.

R-UCLA Scale

In this study, the UCLA LS loneliness scale by Russell et al [45] in the Polish version of the Revised UCLA Loneliness Scale (R-UCLA) was used to assess the level of loneliness, after validation by Kwiatkowska et al [46]. The scale consists of 20 statements, respondents can indicate one of 4 responses (1 = I never feel this way, 4 = I often feel this way). The total scale score is the sum of the scores of the 3 subscales: belongings and affiliation, intimate others and social others [47]. The maximum score that can be obtained is 80. According to the interpretation for the total scale, 4 levels of loneliness were defined: high loneliness level − 65–80; moderately high loneliness level − 50–64 points; moderate loneliness level − 35–49 points; low loneliness level − 20–34 points [48].

In this study, the internal consistency of R-UCLA was a = 0.91 for total score, α = 0.89 for intimate others, α = 0.87 for social others, α = 0.71 for belonging and affiliation.

Statistical method

The normality of distributions was tested using the Shapiro-Wilk test, and variance homogeneity was assessed with Levene's test. Differences between groups were evaluated using one-way ANOVA for more than two comparison groups, or Welch's test with Tukey's post-hoc tests if variance equality was not assumed. For small and highly varied group sizes, the Kruskal-Wallis test with Dunn's post-hoc test was used. For two comparison groups, the independent t-test or the Cochran-Cox test was applied if variance equality was not met, and the Mann-Whitney U test was used for small and varied group sizes. Scale reliability was analyzed using Cronbach's alpha. Calculations were performed using Statistica 10.0 software, with p-values ≤ 0.05 considered statistically significant.

A total of 438 men took part in the study. The average age of the men in the examination was 45.61 ± 15.64 years, the youngest subject was 16 years old and the oldest was 82 years old. In the examination group, 65.8% of the subjects were in a relationship, the majority of the subjects (50.0%) had a secondary or post-secondary education, those working accounted for 64.8%. A total of 64.7% of people came from cities, 35.4% from rural areas. Most of the study respondents lived with their family (59.2%). The financial situation was rated as very good by 5.3%, rather bad by 9.4% and very bad by 2.5%. The presence of chronic diseases was indicated by 45.2% of the examination subjects. According to the HADS-M scale, a higher level of depression was observed among men rating their financial situation as worse (p = 0.000), and among those with the presence of chronic illnesses (p ≤ 0.001), as well as those who do not make decisions about their finances (p = 0.003). Also, a higher score, although not statistically significant, was obtained by study subjects aged 31–40 years (M = 16.29). With regard to the level of loneliness according to the R-UCLA scale, significantly lower levels of loneliness (p = 0.006) were observed among respondents with secondary or post-secondary education (M = 39.72), those in a relationship (M = 38.33) compared to those who were single (M = 44.70) and those living only with a spouse/partner (M = 37.89). Higher levels of loneliness were shown by those not in work and those who do not decide on their finances (M = 46.72), as well as men who rated their financial situation as very bad (M = 50.55) and rather bad (M = 42.27). Detailed data is provided in Table 1.

Table 1

Sociodemographic variables and HADS-M; R-UCLA (n = 438) scale scores
Parameter	%	HADS-M			R-UCLA
Parameter	of All Subjects	M	SD	t/H/r	M	SD	F/t//H/Z
Age
Up to 30 years	20.1	15.53	8.54	F = 1.240	44.75	12.00	F = 2.140
31–40 years	18.7	16.29	9.80	p = 0.293	42.32	9.85	p = 0.075
41–50 years	20.1	12.77	8.39		39.88	10.78
51–60 years	18.9	12.43	10.06		37.99	10.42
over 60 years	22.1	12.75	9.45		37.85	9.33
Education
primary or lower secondary school	5.7	15.92	8.71	H = 3.389	47.64	9.85	H = 12.367
basic education	28.3	14.04	9.20	p = 0.335	40.42	10.44	p = 0.006
secondary or post-secondary school	50.0	13.38	9.50		39.72	10.50
higher	16.0	14.67	9.44		40.57	11.84
Marital status
In relationship	65.8	13.78	9.60	t = 0.491	38.33	9.78	t = 6.083
Single	34.0	14.25	8.87	p = 0.624	44.70	11.46	p < 0.001
Place of residence
Village	35.4	14.66	9.26	F = 1.709	40.81	11.18	F = 0.923
city with up to 200,000 inhabitants	41.6	14.08	9.71	p = 0.182	40.96	10.53	p = 0.391
city of over 200,000 inhabitants	23.1	12.49	8.77		39.22	10.63
Occupational status
Workers	64.8	13.75	9.03	F = 0.060	39.74	10.60	F = 8.018
pensioners	26.2	14.05	10.38	p = 0.996	39.53	10.00	p = 0.046
Students	6.1	13.32	7.88		45.56	12.17
non-working	2.9	14.42	10.20		46.67	14.30
With whom he/she lives
Alone	10.6	13.9	8.8	H = 0.498	43.29	11.98	H = 9.236
Only with spouse/partner	30.3	13.38	9.17	p = 0.780	37.89	8.61	p = 0.010
With family (children/relatives)	59.2	14.20	9.66		41.10	11.34
Number of persons in the household
1 person	10.3	13.91	8.67	F = 2.478	43.87	11.66	F = 5.092
2 persons	29.5	12.24	8.56	p = 0.061	38.13	9.00	p = 0.002
3 persons	27.6	14.64	9.99		41.62	11.62
4 persons and more	32.4	14.72	9.55		40.70	10.93
Financial decision making
Decides or co-decisions	89.3	13.31	9.24	Z = 2.929	39.71	10.59	Z = 3.435
They are not decided	10.7	18.33	9.29	p = 0.003	46.72	10.83	p < 0.001
Incomes
No income	3.1	15.46	9.99	H = 4.739	47.38	14.22	H = 16.267
Up to 2000 zł	19.1	14.14	9.98	p = 0.315	42.44	11.52	p = 0.002
2001–3000 zł	23.5	15.27	9.60		42.49	10.71
3001–4000 zł	25.4	13.60	8.83		38.15	10.58
Above 4000 zł	28.8	12.63	8.91		38.53	9.63
Evaluation of the financial situation
Very bad	2.5	26.09	7.54	H = 29.137	50.55	8.61	H = 13.575
Rather bad	9.4	18.12	9.84	p = 0.001	42.27	10.65	p = 0.009
Neither good nor bad	45.3	13.88	9.16		41.08	11.15
Rather good	37.5	12.56	8.86		38.93	10.11
Very good	5.3	10.22	7.84		39.30	10.85
Presence of chronic diseases
has chronic diseases	45.2	16.35	10.24	Z = 4.417	41.23	10.52	Z = 1.617
does not have	54.8	11.91	8.04	p < 0.001	39.90	10.99	p = 0.106

F- Levene's test; t – Student’s t-test; H – Kruskal-Wallis test; Z – Mann–Whitney U-test; p – statistical significance.

On the HADS-M scale, participants scored an average of 13.91 ± 9.35. The average scores on the anxiety subscale were 6.51 ± 4.29, on the depression subscale 5.14 ± 4.29, and on the irritability subscale, the average scores were 7.39 ± 5.26. On the loneliness scale, the average score was 40.50 ± 10.78 (Table 2).

Table 2

Presents data on Anxiety, Depression, Irritability measured by the HADS-M scale, and Loneliness assessed by the R-UCLA scale
HADS-M	Variable	M	Med.	Min.	Max.	SD
	Anxiety subscale	6.51	5.00	0.00	21.00	4.55
	Depression subscale	5.14	4.00	0.00	20.00	4.29
	Irritability subscale	2.25	2.00	0.00	6.00	1.71
	Total score	13.91	12.00	0.00	47.00	9.35
R-UCLA	Belongings and affiliation	9.58	9.00	5.00	20.00	3.03
	Intimate others	22.32	21.00	10.00	40.00	661
	Social others	8.59	8.00	5.00	20.00	3.30
	Total score	40.50	40.00	20.00	72.00	10.78

In the HADS-M scale, 20.77% of men were found to have disorders, and 16.21% were in the borderline state. Anxiety disorders were identified in 21.91% of participants, with 13.92% borderline. In the depression subscale, 12.55% had disorders, and 18.49% were borderline. Irritability disorders were noted in 27.62%, with 13.47% borderline.

Low levels of loneliness were observed in 35.16% of participants, moderate in 41.55%, moderately high in 21.00%, and very high in 2.30% (Table 3).

Table 3

Participants’ results in the HADS-M scale; R-UCLA
Scale	Parameter		n	%
HADS-M	Anxiety Subscale	No Disorders	281	64.15
		Borderline states	61	13.92
		Presence of Disorders	96	21.91
	Depression Subscale	No Disorders	302	68.94
		Borderline states	81	18.49
		Presence of Disorders	55	12.55
	Irritability Subscale	No Disorders	272	62.10
		Borderline states	45	10.27
		Presence of Disorders	121	27.62
	Total score	No Disorders	276	63.01
		Border conditions	71	16.21
		Occurrence of disorders	91	20.77
R-UCLA	Total score	Low level	154	35.16
		Moderate level	182	41.55
		Moderately high level	92	21.00
		High level	10	2.30

Many countries face a deficit in care for individuals with mental health issues, including those with anxiety and depression symptoms. Addressing this issue requires innovative approaches to diversify and enhance the level of care for these conditions. An important aspect is to engage in promotional, educational, and preventative actions [12]. However, the priority should be the early identification of individuals in need of psychological or psychiatric help, and to raise public awareness that seeking such help is not associated with shame or a lower self-perception.

This study evaluated anxiety levels, depression symptoms, and perceived loneliness among men in Poland. Depression symptoms were observed in 12.5% of participants, with 18.49% in borderline states. Anxiety was present in 21.91% of men, with 13.92% in borderline states. Irritability affected 27.62% of men, with 10.27% in borderline states. Similar depression rates were found in other studies, including one in Germany where 12.2% of men showed major depression symptoms. The anxiety level in this study was lower compared to our observations. Mild anxiety symptoms affected 23.8% of men, moderate anxiety 6.2%, and severe anxiety 4.4% [49]. In a group of Chinese men, moderate to severe depression was noted in 12.5% of participants, with mild depression symptoms in 17.6% of male individuals. Meanwhile, mild anxiety symptoms were experienced by 20.9% of men, with moderate to severe anxiety in 11%. In research that included Iranian men, 16.1% suffered from severe anxiety, and 20.3% indicated a moderate level of anxiety [51]. Pradeepa's study observed that anxiety in men was positively associated with an increased intensity of depression symptoms [52].

In our literature search, we found one of the few studies showing that the risk of mental disorders such as anxiety and depression was higher in men than in women, significantly associated with financial issues and income levels [53]. Arias - de la Torre and colleagues in their population study across 27 European countries highlighted the impact of income on depression symptoms, noting a decrease in depression with higher income. Another significant factor exacerbating depression symptoms in men was chronic illness [54].

In our study, higher levels of depression and anxiety were found in men who rated their financial situation as very poor, those who had no control over their finances, and individuals dealing with any chronic disease. Financial issues or physical illnesses in men can challenge traditional masculine ideals, leading to feelings of failure since societal expectations often dictate that men should be strong and successful. From a young age, boys are taught that expressing sadness or crying is shameful, leading to a tendency among men to avoid seeking medical help for emotional issues related to depression, rarely discussing their feelings with close ones, and often not acknowledging their problems, complicating diagnosis when they do consult a doctor [55]

In our project, we didn't obtain statistically significant results regarding age, education, marital status, or the participants' living areas. However, we found that the worst depression symptoms appeared in men aged 31 to 40. It was also noted that men with lower education, who were single, and living in rural areas, faced these issues more frequently. In a study by Zhou et al., low education, rural living, and poor economic status in a group of Chinese men correlated with higher depression symptoms, with slightly higher rates in men (17.6%) compared to women (17%) [56]. Other authors provided similar data regarding the level of education, but the symptoms of depression in these studies deepened with increasing age [54,57]. Similar findings regarding education levels were reported by other authors, with depression symptoms intensifying with age [54,57]. A study focusing on rural Chinese men observed higher depression rates among unmarried individuals, worsening with age, especially in the younger demographic of 20 to 40 years, which aligns with the age group in our study showing the highest depression symptom levels[58]. Zhou et al.'s subsequent research confirmed the highest depression rates among single men with lower education and financial status [59].

Research on loneliness and depression shows a two-way relationship between them. Higher levels of loneliness predict the occurrence of depressive symptoms in the future and vice versa, where loneliness can adversely affect the course of depression. Studies during the COVID-19 pandemic confirmed that loneliness is a significant factor in depressive and anxious symptoms, particularly among men and younger people. The relationship between loneliness and depression symptoms was stronger in men compared to women [62]. Gender was also negatively related to loneliness, with men reporting it more frequently than women, although a study by Lee et al. [32,63] found a significantly lower level of loneliness in men (36%) compared to women (64%) [61].

This study did not find a significant relationship between participants' age and their perception of loneliness. The highest levels of loneliness were observed in men up to the age of 30, a finding also supported by Hawkley et al.'s [64] research on age differences in loneliness among genders in the USA. In the German population, 20.8% of men aged 16–24 and 17.1% of those aged 25–34 reported feeling lonely, with the highest loneliness rates in the 45–54 age group [65].

The narrative review suggests that marital status, living conditions, and characteristics of personal social networks are considered predictors of loneliness both before and during the COVID-19 pandemic. [66]. In this study, loneliness perception was higher among single men. Reinwarth et al.'s research showed significantly lower loneliness among men in relationships (13%) compared to those not in relationships (30%). The highest loneliness rates were reported by unmarried men aged 55–64. [65]. Living without a spouse or partner among individuals aged 50–70 was more strongly associated with loneliness in men than in women. [67]. Research indicates that being in a relationship offers greater protective benefits against loneliness for men than for women. [66]. In men, literature has confirmed a negative correlation between perceived loneliness and household size. [66,68]. In this study, the least lonely men were those living in two-person households and those living only with a spouse/partner. Conversely, the study found that living with children or other family members does not protect against loneliness, a finding also noted by other researchers. [69,70].

Living in rural areas is considered a risk factor for loneliness.[63,71]. The study did not confirm significant differences in the perception of loneliness based on men's place of residence. In this study, men with basic education, no income, and those who rated their financial situation as very poor perceived loneliness the highest. In the overall Dutch sample, it was shown that risk factors associated with higher levels of loneliness were being male, lower level of education, and inadequate financial resources.[72]. The demographic variables that were significant for loneliness in the general population in Slovenia were marital status and employment status. [63]. Completing higher education was associated with approximately an 8% difference in the likelihood of loneliness among men in the study by Kung et al. [68]. A study conducted in the USA also showed that loneliness is best explained, among other factors, by household income [73]. Data collected from 14 European countries confirmed that among men aged over 65, the prevalence of loneliness was higher among the least affluent (22.08%) and decreased with increasing affluence [74].

This study highlighted the highest levels of loneliness among unemployed men. Research in higher-income countries shows a correlation between loneliness and unemployment, with the association growing stronger with increased loneliness, peaking at ages 30–34 and 50–59. Unemployment has been linked to at least a 40% increase in the likelihood of reporting loneliness [75]. Gender differences didn't significantly impact the relationship between loneliness and employment status [76]. In the UK, unemployed men are estimated to have a 3.1% higher chance of feeling lonely compared to those who are employed [68].

Given that loneliness is a significant public health issue, it's crucial to identify which subgroups of men are more at risk due to sociodemographic factors..

In this study, one fifth of participants showed anxiety disorders, and every tenth man had depressive disorders. These were more prevalent among men with a negative view of their financial situation, those not in control of their finances, individuals with chronic diseases, and younger men.

Every fifth man experienced a moderately high level of loneliness. Higher loneliness was more prevalent among men with lower education, who were single, living alone, unemployed, with a negative assessment of their financial situation, and lacking financial decisiveness.

Screening studies for mental well-being assessment among men should continue and be a fundamental part of public health due to the lower detectability of mental health issues and the higher rate of successful suicides in the male group.

Limitations of the study

Our study, however, had certain limitations. Being cross-sectional, it might not fully capture the mental health status of the male population over time. The surveys were filled out and sent back through the internet, potentially excluding potential respondents without internet technology access or with limited knowledge on how to use it. Moreover, differences between our study's results and those of other studies could be due to methodological differences related to the use of different scales. The study has its strengths, including the use of random sampling. The sample structure mirrors the demographic composition of the country's population in terms of gender, age, education, size of the place of residence, and region, making it representative of the studied population. There is also evidence suggesting that online surveys tend to have higher disclosure rates for sensitive topics [77] and a higher level of data reliability, possibly due to reduced privacy concerns [78].

Acknowledgements

Not applicable.

Authors’ Contributions

Conceived study: AI, EK, BD, Study implementation and procedures: EK, BD, AI, Data analysis: BD, AI, Wrote paper: EK, BD, AI. All authors have read and approved the final version of the manuscript.

Funding

This research received no external funding.

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to confidentiality, but data is accessible from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

Research has been performed in accordance with the Declaration of Helsinki. It was voluntary for the subjects to answer the questionnaire, and they had the right to withdraw their participation at any time. All the answers were treated as strictly confidential, and the participants were guaranteed full anonymity. The subjects provided their informed consent to participate in the study. The study was approved by the Bioethics Committee at the Medical University of Warsaw (approval no AKBE/232/2020).

Consent for publication

Not applicable.

Conflicts of Interest

The authors declare no conflict of interest.

Author details

¹Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warszawa, Poland.

²Department of Basic Nursing and Medical Teaching, Chair of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland.

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Mental Well-being and Perception of Loneliness Among Men in Poland

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Hospital Anxiety and Depression Scale (HADS-M)

R-UCLA Scale

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