Loneliness during the first wave of the SARS-CoV-2 pandemic—results of the German National Cohort (NAKO)

Abstract

Background: Early during the pandemic and the following protective countermeasures, an interest in the consequences of the enacted restriction of social contacts for the mental health of the population arose. Loneliness describes the perceived quality of one’s own contacts and relationships with other individuals. Several prior studies reported associations of loneliness with different somatic and psychiatric disorders. Aim: To analyse the frequency of loneliness and its association with depression and anxiety symptoms in the first wave of the pandemic in Germany in May 2020. Methods: The German National Cohort (NAKO) had recruited and examined 205,000 individuals aged 20 to 69 years in 18 study centres across Germany between 2014 and 2019. The follow-up examination was temporarily stopped due to the pandemic between March and July 2020. In this period a COVID-related questionnaire was developed and sent to all participants. We analysed the first 113,928 questionnaires that were sent back within four weeks in May 2020. Loneliness was assessed with the three-item UCLA Loneliness Scale and anxiety and depression symptoms were collected using the PHQ‑9 and GAD‑7 scales from the Patient Health Questionnaire. Results: Among the NAKO participants, 31.7% reported to be lonely in May 2020. Women and young adults reported more loneliness than men and older adults. With increasing scores of loneliness, the severity of depression and anxiety symptoms also steadily increased. Individuals who were lonely during the pandemic had already reported higher PHQ‑9 and GAD‑7 scores during the baseline examination on average 2.5 years earlier, compared to those who did not feel lonely. Conclusions: Among participants of the German National Cohort, we observed an increase in loneliness during the first wave of the SARS-CoV‑2 pandemic in spring 2020 and a strong relationship of increasing loneliness with decreasing mental health.