Loneliness and health-related quality of life in Chinese adolescents: the mediating role of depressive symptoms and the moderating role of age.

IF 3.6 2区医学 Q1 PSYCHIATRY

Social Psychiatry and Psychiatric Epidemiology Pub Date : 2025-02-20 DOI:10.1007/s00127-025-02834-2

Wanting Hu, Xiuqiong Feng, Wangnan Cao, Jinghua Li, Shengyu Luo, Li Lin, Dezhong Chen, Weiqing Chen, Vivian Yawei Guo

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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.

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中国青少年的孤独感与健康相关生活质量：抑郁症状的中介作用和年龄的调节作用。

目的：尽管孤独感在青少年中普遍存在，但很少有研究涉及其对健康相关生活质量（HRQOL）的影响。本研究旨在探讨孤独感与青少年生活质量的关系，以及抑郁症状的中介作用和年龄的调节作用。方法：对6743名初中生进行横断面调查，采用6项UCLA孤独感量表和《儿童生活质量量表4.0版》HRQOL量表进行孤独感评估。抑郁症状通过患者健康问卷-9进行评估。采用Pearson相关分析确定各主要变量之间的相关性。建立有调节的中介分析，评估抑郁症状的中介作用和年龄在孤独感与HRQOL的关联中的调节作用。结果：参与调查的青少年中，25.0%（1687人）报告有高度孤独感。研究结果显示，在所有HRQOL维度和总结量表上，孤独感与较低的分数之间存在显著关联。具体来说，孤独感得分每增加一分，HRQOL总量表得分变化-2.06分（95% CI: -2.13至-2.00）。抑郁症状被确定为部分中介，其中介效应从社会功能的24.31%到学校功能的62.50%不等。此外，年龄在上述中介模型中负向调节孤独与抑郁症状的关系。结论：孤独感与青少年较差的HRQOL之间的联系突出了优先考虑这一弱势群体的必要性。我们的研究结果还表明，解决孤独青少年的抑郁症状和年龄差异对于保持其HRQOL的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

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.