{"title":"Loneliness and health-related quality of life in Chinese adolescents: the mediating role of depressive symptoms and the moderating role of age.","authors":"Wanting Hu, Xiuqiong Feng, Wangnan Cao, Jinghua Li, Shengyu Luo, Li Lin, Dezhong Chen, Weiqing Chen, Vivian Yawei Guo","doi":"10.1007/s00127-025-02834-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Despite the alarming prevalence of loneliness in adolescents, few studies addressed its impact on health-related quality of life (HRQOL). This study aimed to investigate the association between loneliness and HRQOL in adolescents, as well as the mediating role of depressive symptoms and the moderating role of age in this association.</p><p><strong>Methods: </strong>A cross-sectional study surveyed 6743 middle school adolescents, assessing loneliness with the 6-item UCLA Loneliness Scale and HRQOL through the Pediatric Quality of Life Inventory Version 4.0. Depressive symptoms were assessed by the Patient Health Questionnaire-9. Pearson correlation analysis was performed to determine the correlation among the main variables. A moderated mediation analysis was established to evaluate the mediating role of depressive symptoms and the moderating role of age in the association between loneliness and HRQOL.</p><p><strong>Results: </strong>Of the participating adolescents, 25.0% (1687) reported experiencing high-level loneliness. The findings revealed a significant association between loneliness and lower scores across all HRQOL dimensional and summary scales. Specifically, with every additional point in loneliness scores, the HRQOL total scale scores changed by -2.06 (95% CI: -2.13 to -2.00) points. Depressive symptoms were identified as a partial mediator, with mediation effects ranging from 24.31% for social functioning to 62.50% for school functioning. Additionally, age negatively moderated the link between loneliness and depressive symptoms in above mediation model.</p><p><strong>Conclusions: </strong>The link between loneliness and poorer HRQOL in adolescents highlighted the need to prioritize this vulnerable group. Our findings also indicated the importance of addressing depressive symptoms and age differences among lonely adolescents to preserve their HRQOL.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Psychiatry and Psychiatric Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00127-025-02834-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Despite the alarming prevalence of loneliness in adolescents, few studies addressed its impact on health-related quality of life (HRQOL). This study aimed to investigate the association between loneliness and HRQOL in adolescents, as well as the mediating role of depressive symptoms and the moderating role of age in this association.
Methods: A cross-sectional study surveyed 6743 middle school adolescents, assessing loneliness with the 6-item UCLA Loneliness Scale and HRQOL through the Pediatric Quality of Life Inventory Version 4.0. Depressive symptoms were assessed by the Patient Health Questionnaire-9. Pearson correlation analysis was performed to determine the correlation among the main variables. A moderated mediation analysis was established to evaluate the mediating role of depressive symptoms and the moderating role of age in the association between loneliness and HRQOL.
Results: Of the participating adolescents, 25.0% (1687) reported experiencing high-level loneliness. The findings revealed a significant association between loneliness and lower scores across all HRQOL dimensional and summary scales. Specifically, with every additional point in loneliness scores, the HRQOL total scale scores changed by -2.06 (95% CI: -2.13 to -2.00) points. Depressive symptoms were identified as a partial mediator, with mediation effects ranging from 24.31% for social functioning to 62.50% for school functioning. Additionally, age negatively moderated the link between loneliness and depressive symptoms in above mediation model.
Conclusions: The link between loneliness and poorer HRQOL in adolescents highlighted the need to prioritize this vulnerable group. Our findings also indicated the importance of addressing depressive symptoms and age differences among lonely adolescents to preserve their HRQOL.
期刊介绍：
Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic.
In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation.
Both original work and review articles may be submitted.
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