title: Loneliness predicts pain, depression, and fatigue: understanding the role of immune dysregulation.
abstract: OBJECTIVE
  The pain, depression, and fatigue symptom cluster is an important health concern. Loneliness is a common risk factor for these symptoms. Little is known about the physiological mechanisms linking loneliness to the symptom cluster; immune dysregulation is a promising candidate. Latent herpesvirus reactivation, which is reflected by elevated herpesvirus antibody titers, provides a window into immune dysregulation. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are two common herpesviruses.
  
  
  METHODS
  Participants were 200 breast cancer survivors who were 2 months to 3 years post-treatment at the time of the study. They completed questionnaires and provided a blood sample that was assayed for CMV and EBV antibody titers.
  
  
  RESULTS
  Lonelier participants experienced more pain, depression, and fatigue than those who felt more socially connected. Lonelier participants also had higher CMV antibody titers which, in turn, were associated with higher levels of the pain, depression, and fatigue symptom cluster. Contrary to expectations, EBV antibody titers were not associated with either loneliness or the symptom cluster.
  
  
  CONCLUSIONS
  The pain, depression, and fatigue symptom cluster is a notable clinical problem, especially among cancer survivors. Accordingly, understanding the risk factors for these symptoms is important. The current study suggests that loneliness enhances risk for immune dysregulation and the pain, depression, and fatigue symptom cluster. The present data also provide a glimpse into the pathways through which loneliness may impact health.
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH 614, United States. lisa.jaremka@osumc.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Jaremka
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Fagundes
authors.forename: Ronald
authors.initials: R
authors.lastname: Glaser
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Bennett
authors.forename: William B
authors.initials: WB
authors.lastname: Malarkey
authors.forename: Janice K
authors.initials: JK
authors.lastname: Kiecolt-Glaser
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D001943:Breast Neoplasms / Q000276:immunology / Q000523:psychology; D003587:Cytomegalovirus / Q000276:immunology*; D003863:Depression / Q000150:complications / Q000276:immunology* / Q000523:psychology; D005221:Fatigue / Q000150:complications / Q000276:immunology* / Q000523:psychology; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000276:immunology* / Q000523:psychology; D017741:Survivors / Q000523:psychology
chemical_list: D000914:Antibodies, Viral