Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May;55(5):589-597.
doi: 10.1007/s00127-019-01785-9. Epub 2019 Nov 6.

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

Jason I Chen  1   2 , Elizabeth R Hooker  3 , Meike Niederhausen  3   4 , Heather E Marsh  3 , Somnath Saha  3   5 , Steven K Dobscha  3   6 , Alan R Teo  3   6
Affiliations

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

Jason I Chen et al. Soc Psychiatry Psychiatr Epidemiol. 2020 May.

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.

Keywords: Health services; Major depression; Social support; Suicide; Veterans.

PubMed Disclaimer

References

    1. Allen J, Balfour R, Bell R, Marmot M (2014) Social determinants of mental health. Int Rev Psychiatry 26(4):392–407 - PubMed
    1. Rosenquist JN, Fowler JH, Christakis NA (2011) Social network determinants of depression. Mol Psychiatry 16(3):273–281. 10.1038/mp.2010.13 - DOI - PMC - PubMed
    1. Santini ZI, Koyanagi A, Tyrovolas S, Mason C, Haro JM (2015) The association between social relationships and depression: a systematic review. J Affect Disord 175:53–65 - PubMed
    1. Perlman D, Peplau LA (1982) Theoretical approaches to loneliness Loneliness: a sourcebook of current theory, research and therapy. Wiley, Hoboken, NJ, pp 123–134
    1. 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):453–463 - PMC - PubMed

LinkOut - more resources