title: Pain, depression, and fatigue: loneliness as a longitudinal risk factor.
abstract: OBJECTIVE
  Pain, depression, and fatigue function as a symptom cluster and thus may share common risk factors. Interpersonal relationships clearly influence health, suggesting that loneliness may promote the development of the pain, depression, and fatigue symptom cluster. We hypothesized that loneliness would be related to concurrent symptom cluster levels and increases in symptom cluster levels over time.
  
  
  METHODS
  We utilized two observational studies with distinct longitudinal samples. Study 1 was a sample of cancer survivors and benign controls (N = 115) assessed annually for 2 years. Study 2 was a sample of older adults caring for a spouse with dementia (caregivers) and non-caregiver controls (N = 229) assessed annually for 4 years. Participants completed annual measures assessing loneliness, pain, depression, and fatigue.
  
  
  RESULTS
  Across both samples, lonelier participants experienced more concurrent pain, depression, and fatigue and larger increases in symptom cluster levels from one year to the next than less lonely participants. Sleep quality did not mediate the results in either study. All analyses were adjusted for relevant demographic and health variables.
  
  
  CONCLUSIONS
  Two longitudinal studies with different populations demonstrated that loneliness was a risk factor for the development of the pain, depression, and fatigue symptom cluster over time. The current research helps identify people most at risk for pain, depression, and fatigue, and lays the groundwork for research about their diagnosis and treatment. These data also highlight the health risks of loneliness; pain, depression, and fatigue often accompany serious illness and place people at risk for poor health and mortality.
authors: Institute for Behavioral Medicine Research.
authors: Lisa M
authors: LM
authors: Jaremka
authors: College of Public Health.
authors: Rebecca R
authors: RR
authors: Andridge
authors: Institute for Behavioral Medicine Research.
authors: Christopher P
authors: CP
authors: Fagundes
authors: National Cancer Institute.
authors: Catherine M
authors: CM
authors: Alfano
authors: Comprehensive Cancer Center.
authors: Stephen P
authors: SP
authors: Povoski
authors: Comprehensive Cancer Center.
authors: Adele M
authors: AM
authors: Lipari
authors: Comprehensive Cancer Center.
authors: Doreen M
authors: DM
authors: Agnese
authors: Comprehensive Cancer Center.
authors: Mark W
authors: MW
authors: Arnold
authors: Comprehensive Cancer Center.
authors: William B
authors: WB
authors: Farrar
authors: Comprehensive Cancer Center.
authors: Lisa D
authors: LD
authors: Yee
authors: Comprehensive Cancer Center.
authors: William E
authors: WE
authors: Carson
authors: Comprehensive Cancer Center.
authors: Tanios
authors: T
authors: Bekaii-Saab
authors: Comprehensive Cancer Center.
authors: Edward W
authors: EW
authors: Martin
authors: Comprehensive Cancer Center.
authors: Carl R
authors: CR
authors: Schmidt
authors: Institute for Behavioral Medicine Research.
authors: Janice K
authors: JK
authors: Kiecolt-Glaser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D016022:Case-Control Studies; D003704:Dementia; D003863:Depression / Q000523:psychology*; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008132:Loneliness / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology; D009820:Ohio; D010146:Pain / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D017741:Survivors / Q000523:psychology*; D013577:Syndrome
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