Loneliness and related constructs associated with isolation are public health problems with increasing prevalence. The aim of this umbrella was to collate and grade evidence analyzing actual and subjective loneliness as a health risk factor. Following prospective registration, a systematic search was conducted in Pubmed, Embase, Scopus, Web of Sciences, psycoINFO and Cochrane Library until August 2023. Systematic reviews assessing the association between actual and subjective loneliness with adverse health outcomes were selected. Risk of bias was evaluated using AMSTAR-2 tool. Data were tabulated and synthesis was narrative. A total of 13 systematic reviews was selected (four included meta-analysis). The methodological quality was critically low in 10 reviews (76.92%) and low in 3 (23.08%). Results showed that loneliness was related to poor well-being and increase the risk of negative mental and physical health. The available data suggested but did not allow the confirmation of a causal association. Most constructs of loneliness seem to be related to mental and physical health conditions. A preventive strategy ought to be recommended, especially for vulnerable populations.

BACKGROUND: An increased number of patients seek help for loneliness in primary care.
OBJECTIVE: To analyze whether loneliness was associated with a higher utilization of healthcare facilities.
METHODS: Observational, retrospective study based on the review of routinely coded data in the digital medical record system in a random sample of patients aged 65 or older, stratified by population size of their residence area. A minimum sample size was estimated at 892 medical records. Loneliness was defined as the negative feeling that arises when there is a mismatch between the quantity and quality of a person\'s social relationships and those, they desire. Thirty-three primary care nurses (30 females and 3 males) were reviewing the data.
RESULTS: A total of 932 medical records of patients were reviewed (72% belonged to female patients). Of these, 657 individuals were living alone (71.9%). DeJong Scale average scores was 8.9 points (SD 3.1, 95CI 8.6-9.1). The average annual attendance to primary care ranged from 12.2 visits per year in the case of family practice, 10.7 nurse, 0.7 social workers. The average number of home visits was 3.2, and the urgent consultations attended at health centers were 1.5 per year. Higher feelings of loneliness were associated with extreme values in the frequency of healthcare resource usage. Compared to their peers of the same age, the additional healthcare resource consumption amounted to €802.18 per patient per year.
CONCLUSIONS: Loneliness is linked to higher healthcare resource usage in primary care, with individuals experiencing poorer physical and mental health utilizing these resources up to twice as much as their peers of the same age.

el envejecimiento poblacional es un fenómeno mundial. Los problemas de salud mental, altamente prevalentes en este grupo, impactan en la vida de los individuos, sus familias y la sociedad en su conjunto.
identificar brechas de conocimiento y prioridades de investigación en salud mental del adulto mayor en Argentina.
diseño cuali-cuantitativo, en tres etapas: (1) diagnóstico de situación, (2) evaluación global de necesidades de investigación y (3) ejercicio de priorización basado en la Matriz de Estrategias Combinadas validada para Argentina (MECA).
con base en las primeras dos etapas del estudio se identificaron dos áreas temáticas investigar en el país y dimensiones priorizadas: (a) soledad-aislamiento y (b) deterioro cognitivo y demencia. Como resultado del ejercicio de priorización surgieron las siguientes dimensiones: en relación con soledad-aislamiento: 1. efecto de los programas, 2. falta de acceso a los recursos, 3. capacidad de adaptación a los contextos locales (integración social del adulto mayor) y 4. calidad de servicios. En relación con deterioro cognitivo y demencia: 1. impacto cuidadores y entorno, 2. barreras para la implementación de guías y capacitación, 3. estudios de costo-efectividad sobre intervenciones y calidad de vida, y 4. recolección y publicación de datos epidemiológicos.
se debe enfatizar la importancia de fortalecer la investigación en Argentina sobre la implementación y difusión de intervenciones de promoción, prevención y prestación de servicios en la salud mental del adulto mayor.

The present study aims to evaluate the effectiveness of the CRENCO project which was carried out during the COVID-19 pandemic including intergenerational activities shared by students from primary and secondary education and users of two centers for older adults and a day hospital in Catalonia. The effectiveness was assessed in terms of well-being in older adults and on negative stereotypes about the elderly in primary and secondary students.
Three interventions were carried out in which 32 older persons (9 users of centers for older adults and 23 of a day hospital), 99 primary students and 56 secondary students participated. Participants answered a questionnaire before and after the interventions. Through multilevel linear models for repeated measures, changes in feelings of loneliness, social support, anxiety and depressive symptoms, self-reported health and health-related quality of life were evaluated in older people. In primary and secondary students, changes in age stereotypes were evaluated.
Health-related quality of life and self-reported health improved statistically after the interventions in older persons. Users of the day hospital also reported an improvement in social support. Primary school students improved their age stereotypes; no statistically significant changes were detected in secondary students.
The results of the present study contribute to underlining the importance of intergenerational programs such as the one proposed by CRENCO, capable of improving well-being and providing a more realistic vision of the older adults. Our results suggest that these programs should be implemented during childhood in order to prevent the proliferation of ageist stereotypes in later life stages.

Hopelessness is characterized by a set of negative cognitive schemas about the future, conceptualized on the basis of three dimensions: affective, motivational and cognitive. This construct is linked to loneliness, the incidence of which in older adults is increasingly high. The aim of this research is to test whether hopelessness factors predict levels of loneliness in older adults.
138 non-institutionalized persons from Valencia city between 65-90 years old participated, with a mean age of 73.67 (SD=4.8), and 59.4% were women. The Beck Hopelessness Scale (BHS) and University of California Los Angeles Loneliness Scale (UCLA) were administered to assess participants.
The motivational and cognitive factors acted as statistically significant predictors of loneliness, while the affective factor was not presented as a significant factor. The final model obtained an R2adj=.442, F(3, 87)=23.97, p<.001.
Loneliness is a phenomenon of great concern in the field of gerontology due to its high incidence and impact. The results indicate that hopelessness, specifically loss of motivation and negative expectations about the future, are critical issues for the development of feelings of loneliness in older adults. Thus, it is relevant to pay attention to these variables in order to apply loneliness prevention programs.

OBJECTIVE: To identify the main conditioning factors that Primary Care professionals indicate when implementing and developing interventions on isolation and loneliness.
METHODS: Qualitative research with grounded theory, systematic analysis and narrative design of topics.
METHODS: Developed in 12 Primary Care centres of the Health District of Córdoba and Guadalquivir, covering urban and rural areas.
METHODS: Three profiles were identified: family medicine/community care, community nursing and case management nursing. The selection was carried out among those who showed greater motivation and commitment to an intervention on isolation/loneliness.
METHODS: Purposive sampling. The work was based on individual in-depth interviews, focus groups and dialogic interviews.
RESULTS: (a) Distorted images persist about loneliness/social isolation and living alone that make it challenging to identify; (b) the main disruptive determinants in the structure and organization of the care system have to do with the absence of screening programs, the hegemony of the biomedical model and the deficit of resources (in light of this model); (c) the main facilitators are linked to the nursing role, privileged for these interventions according to the participants; and, finally, (d) personal components are necessary, both from the older adult and from the professionals.
CONCLUSIONS: Intervention on social isolation and loneliness in Primary Care is conditioned by organizational and structural, professional and personal factors. It is essential to take them into account in order to guarantee their feasibility.

The COVID-19 pandemic has forced the confinement of most populations worldwide, through stay-at-home orders. Children have continued their education process at home, supervised by parents, who, in most cases, have adopted the role of prime drivers of their learning processes. In this study, the psychological impact of confinement was explored, as well as the relationship of the forced homeschooling situation with psychological well-being. During their confinement, 400 individuals residing in Spain-165 without children at home (Group 1), 104 parents who dedicated little time to homeschooling (Group 2), and 131 who dedicated more time to homeschooling (Group 3)-responded to an online questionnaire. The results show that confinement threatened the mental health of all the participants but especially Group 3 individuals, who had the highest loneliness, anxiety, and stress levels. Moreover, loneliness, perception of discomfort due to homeschooling, and anxiety exacerbated the stress experienced during confinement. Discomfort due to the homeschooling situation was especially relevant in explaining anxiety and stress for Group 3 individuals. These results suggest that forced homeschooling could be associated with the negative consequences that confinement has on individuals\' mental health. Moreover, the results suggest that parents who dedicate more time to homeschooling feel more unprotected and more stressed due to the homeschooling in comparison to Group 2 individuals. Health professionals must pay special attention to parents who dedicate more time to homeschooling, and governments and schools must emphasize social support provision to families during homeschooling situations.
La pandemia de la COVID-19 ha impuesto el confinamiento de la mayoría de las poblaciones de todo el mundo mediante órdenes de quedarse en casa. Los niños han continuado su proceso de escolarización en sus hogares, supervisados por los padres, quienes, en la mayoría de los casos, han adoptado el papel de impulsores principales de sus procesos de aprendizaje. En este estudio se analizó el efecto psicológico del confinamiento, así como la relación de la situación forzada de enseñanza en el hogar con el bienestar psicológico. Durante su confinamiento, 400 personas residentes en España -165 sin niños en casa (grupo 1), 104 padres que dedicaron poco tiempo a la enseñanza en el hogar (grupo 2), y 131 que dedicaron más tiempo a la enseñanza en el hogar (grupo 3)- respondieron un cuestionario en línea. Los resultados demuestran que el confinamiento amenazó la salud mental de todos los participantes, pero especialmente la de las personas del grupo 3, quienes demostraron mayores niveles de soledad, ansiedad y estrés. Además, la soledad, la percepción de incomodidad a consecuencia de la enseñanza en el hogar, y la ansiedad agravaron el estrés sufrido durante el confinamiento. La incomodidad provocada por la situación de enseñanza en el hogar fue especialmente importante para explicar la ansiedad y el estrés de las personas del grupo 3. Estos resultados sugieren que la enseñanza forzada en el hogar podría estar asociada con las consecuencias negativas que tiene el confinamiento en la salud mental. Además, los resultados indican que los padres que dedican más tiempo a la enseñanza en el hogar se sienten más desprotegidos y más estresados debido a este tipo de enseñanza en comparación con las personas del grupo 2. Los profesionales de la salud deben prestar especial atención a los padres que dedican más tiempo a la enseñanza en el hogar, y los gobiernos y centros educativos deben brindar más apoyo social a las familias durante las situaciones de enseñanza en el hogar.
2019新冠病毒(COVID-19)大流行病迫使世界各地的大多数人因为留在家里的命令被禁闭。孩子们在家里继续他们的教育过程，由父母监督，在大多数情况下，父母是他们学习过程的主要推动者。在这项研究中，我们探讨了禁闭的心理影响，以及强迫式的家庭教育境况与心理健康的关系。在禁闭期间，居住在西班牙的400名受试者--其中165名家中没有孩子的人（第1组），104名家长很少有时间致力于家庭教育的父母（第2组），以及131名花较多时间致力于家庭教育的父母（第3组）--回答了一份在线调查问卷。结果显示，禁闭威胁着所有参与者的心理健康，但特别是第3组的人，他们的孤独感、焦虑和压力水平最高。此外，孤独感、对家庭教育带来的不适感和焦虑感加剧了禁闭期间的压力。在解释第3组人的焦虑和压力时，由于家庭教育情况造成的不适感尤为重要。这些结果表明，强迫家庭教育可能与禁闭对个人心理健康产生的消极后果有关。此外，研究结果表明，与第2组个体相比，为家庭教育投入更多时间的父母感到更多的不受保护和更多的压力。卫生专业人员必须特别关注那些花更多时间在家庭教育上的父母，而政府和学校必须强调在在家上学的家庭教育情况下向家庭提供社会支持。.

In this paper I discuss Jungian psychological work of the trauma and loss experienced in reaction to COVID-19 with a man who represents a clinical composite. The issues of precarity, a concept used by the philosopher Judith Butler, are combined with the notions of lack and absence of French psychoanalyst André Green. The psychological and societal situation of precarity aroused the man\'s childhood issues that were long repressed. The loneliness, isolation and death from COVID-19 mirrored his personal and the collective responses to the disaster from this global pandemic. He felt on the edge of collapse as what he knew of his world crashed and he found himself unable to cope. The subsequent Jungian work taking place through the virtual computer screen was taxing and restorative simultaneously for both analyst and analysand.
Dans cet article je discute le travail psychologique Jungien sur le traumatisme et la perte dont fait l’expérience un patient en réaction au COVID-19, patient qui représente un composite clinique. Les questions en lien avec la précarité, un concept utilisé par la philosophe Judith Butler, sont combinées avec les notions de manque et d’absence chez le psychanalyste français André Green. La situation psychologique et sociale de précarité a activé les problèmes de l’enfance de cet homme, réprimés depuis longtemps. La solitude, l’isolement et la mort liés au COVID-19 ont fait miroir avec ses réponses personnelles et les réponses collectives au désastre de cette pandémie globale. Il se sentit à la limite de l’effondrement alors que ce qu’il connaissait de son monde s’écroulait et il se trouva dans l’incapacité de faire face. Le travail Jungien qui s’ensuivit, au moyen de l’écran virtuel de l’ordinateur fut éprouvant et réparateur pour l’analysant et l’analyste simultanément.
In diesem Artikel diskutiere ich die Jungianische psychologische Arbeit an Traumata und Verlusten, die als Reaktion auf COVID-19 eingetreten sind, mit einem Mann, der eine klinische Mischung verkörpert. Die Fragen der Unsicherheit (Prekaritaet), ein Konzept der Philosophin Judith Butler, werden mit den Vorstellungen von Mangel und Abwesenheit des französischen Psychoanalytikers André Green kombiniert. Die psychologische und gesellschaftliche Situation der Unsicherheit weckte die lange unterdrückten Kindheitsprobleme des Mannes. Die von COVID-19 verursachte Einsamkeit, die Isolation und der Tod spiegelten seine persönlichen und kollektiven Reaktionen auf die Katastrophe dieser globalen Pandemie wider. Er fühlte sich am Rande des Zusammenbruchs, als das, was er über seine Welt wußte, zusammenbrach und er sich unfähig fühlte, damit umzugehen. Die anschließende Jungianische Arbeit, die virtuell über den Computerbildschirm stattfand, war sowohl für den Analytiker als auch für den Analysanden gleichzeitig anstrengend und aufbauend.
In questo articolo discuto il lavoro psicologico junghiano sul trauma e la perdita nell\'esperienza del COVID-19 con un uomo che rappresenta un caso clinico composito. Il tema della precarietà, un concetto utilizzato dalla filosofa Judith Butler, è combinato con le nozioni di perdita e di assenza dello psicoanalista francese André Green. La situazione di precarietà psicologica e sociale ha risvegliato temi dell\'infanzia del paziente che per lungo tempo erano stati repressi. La solitudine, l\'isolamento e la morte per COVID-19 hanno risvegliato le sue risposte personali, come quelle collettive, alla pandemia globale. Il paziente si è sentito sull\'orlo del baratro poiché il mondo che lui conosceva era crollato e lui si era ritrovato incapace di fare fronte alla distruzione. Il lavoro junghiano si è realizzato attraverso lo schermo del computer ed è stato gravoso, ma ha anche dato sollievo sia al paziente che all\'analista.
В этой статье я обсуждаю юнгианскую психологическую работу с травмой и утратой, пережитыми в связи с Ковид-19. Клиническим материалом послужила работа с мужчиной. Тема нестабильности - понятия, использованного философом Джудит Батлер, рассмотрена в сочетании с представлениями Андре Грина о дефиците и отсутствии. Психологическая и социальная ситуация нестабильности сегодняшнего дня подняла вытесненные проблемы, идущие из детства этого пациента. Одиночество, изоляция и смерть от коронавируса отобразили его личный и коллективный ответ на несчастье, вызванное пандемией. Он чувствовал себя на грани срыва, поскольку мир, каким он его знал, рухнул, и он не мог с этим справиться. Последовавшая юнгианская онлайн работа была одновременно утомительной и восстанавливающий как для аналитика, так и для анализанда.
En el presente trabajo, describo el trabajo psicológico Junguiano, con un hombre que representa un compuesto clínico, acerca del trauma y la pérdida experimentada en reacción al COVID-19. Cuestiones de precariedad, un concepto utilizado por la filósofa Judith Butler, son combinadas con las nociones de falta y ausencia del psicoanalista francés André Green. La situación psicológica y social de precariedad activa temas infantiles del individuo, hasta entonces reprimidos. La soledad, aislamiento y muerte del COVID-19 espejó la suya personal y las respuestas colectivas al desastre de esta pandemia global. Él se encontró en el borde del colapso debido a que lo que él conocía del mundo se quebró, y se encontró imposibilitado de hacer algo con esto. El trabajo Junguiano subsiguiente que tuvo lugar a través de la pantalla virtual de la computadora fue arduo y restaurador simultáneamente para ambos, analista y analizando.
文章讨论了对基于荣格心理流派, 对一位在新冠疫情中经历创伤和丧失的个案的工作, 这位个案是一个临床上的综合案例。关于动荡的话题, 来自哲学家Judith Butler 所提出的概念, 这一概念又融合了法国精神分析师André Green 关于匮乏的观念。动荡的心理与社会状况唤起了个体童年那些一直表现出来的议题。由新冠引发的孤独、隔离与死亡映射了面向全球疫情灾难所唤起的个体的与集体性的反应。他感到处于崩溃的边缘, 因为他感到他的世界要崩塌了, 而他没有能力应对。随之而来的透过虚拟的电脑屏幕进行的荣格式工作, 对于分析师和受分析者来说, 都是即繁重又滋养的。.

To explore the health effects of a community health intervention on older people who are isolated at home due to mobility problems or architectural barriers, to identify associated characteristics and to assess participants\' satisfaction.
Quasi-experimental before-after study.
Five low-income neighbourhoods of Barcelona during 2010-15.
147 participants, aged ≥59, living in isolation due to mobility problems or architectural barriers were interviewed before the intervention and after 6 months.
Primary Health Care teams, public health and social workers, and other community agents carried out a community health intervention, consisting of weekly outings, facilitated by volunteers.
We assessed self-rated health, mental health using the General Health Questionnaire (GHQ-12), and quality of life through the EuroQol scale. Satisfaction with the programme was evaluated using a set of questions. We analysed pre and post data with McNemar tests and fitted lineal and Poisson regression models.
At 6 months, participants showed improvements in self-rated health and mental health and a reduction of anxiety. Improvements were greater among women, those who had not left home for ≥4 months, those with lower educational level, and those who had made ≥9 outings. Self-rated health [aRR: 1.29(1.04-1.62)] and mental health improvements [β: 2.92(1.64-4.2)] remained significant in the multivariate models. Mean satisfaction was 9.3 out of 10.
This community health intervention appears to improve several health outcomes in isolated elderly people, especially among the most vulnerable groups. Replications of this type of intervention could work in similar contexts.

Research has documented that loneliness is a major public health concern, particularly for older adults in the United States. However, previous studies have not elucidated the mechanisms that connect family economic adversity to husbands\' and wives\' loneliness in later adulthood. Thus, using prospective dyadic data over 27 years from 254 enduring couples, the present study investigated how spouses\' mastery, as an intraindividual process, and marital functioning, as a couple process, link midlife family economic adversity to spouses\' later-life loneliness. The results provided support for three linking life course pathways: an adversity-mastery-loneliness pathway, an adversity-marital functioning-loneliness pathway, and a mastery-marital functioning-loneliness pathway. The results also showed spousal contemporaneous dependencies in mastery and loneliness. These findings demonstrate the persistent influence of midlife family economic adversity on husbands\' and wives\' loneliness nearly three decades later and elucidate linking mechanisms involving mastery and couple marital functioning. Findings are discussed as they relate to life course and family systems theories. Implications address multiple levels including national- and state-policies and couple-level clinical interventions.
Las investigaciones han documentado que la soledad es un gran problema de salud pública, particularmente en el caso de los adultos mayores en los Estados Unidos. Sin embargo, hay estudios previos que no han dilucidado los mecanismos que conectan las dificultades económicas familiares con la soledad de los esposos y las esposas en la tercera edad. Por lo tanto, utilizando datos diádicos prospectivos durante 27 años de 254 parejas duraderas, el presente estudió investigó cómo la dominancia de los cónyuges como proceso intraindividual y el funcionamiento conyugal como proceso de pareja vinculan las dificultades económicas familiares de la mediana edad con la soledad de los cónyuges en la tercera edad. Los resultados respaldaron tres vías asociadas en el transcurso de la vida: una vía de dificultades-dominancia-soledad, una vía de dificultades-funcionamiento conyugal-soledad, y una vía de dominancia-funcionamiento conyugal-soledad. Los resultados también demostraron dependencias contemporáneas conyugales en la dominancia y la soledad. Estos resultados demuestran la influencia constante de las dificultades económicas familiares durante la mediana edad en la soledad de los esposos y las esposas casi tres décadas después, y dilucidan los mecanismos conectivos relacionados con la dominancia y el funcionamiento conyugal de la pareja. Se exponen los resultados en relación con el transcurso de la vida y las teorías de sistemas familiares. Las implicancias abordan varios niveles, incluidas las políticas nacionales y estatales, y las intervenciones clínicas a nivel de la pareja.
研究表明孤独是一个主要的公共健康问题，尤其是对美国的老年人。然而，以往的研究并没有阐明糟糕的家庭经济状况与中老年阶段丈夫和妻子的孤独之间的关联机制。鉴于以上原因，本研究调查了作为个体内部过程的配偶的掌控感和作为夫妻过程的婚姻功能，旨在将中年阶段家庭经济困境与配偶晚年的孤独联系起来。研究对象是254对维持较长婚姻关系的伴侣在27年的前瞻性二元数据。研究结果支持了三条相互关联的人生路径:困境-掌控感-孤独路径、困境-婚姻功能-孤独路径和掌控感-婚姻功能-孤独路径。研究结果还显示，配偶在掌控感和孤独感方面同时存在依赖关系。这些发现证明了中年时的家庭经济逆境对丈夫和妻子的孤独感在中年之后的三十年仍有持续影响，并阐明了涉及掌握感和夫妻婚姻功能的关联机制。本文讨论了研究结果，这些研究发现涉及到生命过程和家庭系统理论。本研究的意义涉及多个层面，包括国家和国家政策以及伴侣层面的临床干预。.