小柯机器人

澳大利亚悉尼大学Ding Ding团队对113个国家和地区的孤独患病率进行了系统回顾和荟萃分析。这一研究成果于2022年2月9日发表在《英国医学杂志》上。

为了确定全球人群水平上孤独感患病率的数据可用性、差距和模式，在可行的情况下通过荟萃分析总结世界卫生组织区域内的患病率估计，并评估有数据国家孤独感的时间趋势，研究组在Embase、Medline、PsycINFO和Scopus等大型数据库中检索相关文献，筛选出基于全国代表性样本（n≥292）、仪器验证和2000-19年流行率数据的观察性研究，进行系统回顾和荟萃分析。由两名研究人员独立提取数据，并使用乔安娜·布里格斯研究所（Joanna Briggs Institute）的检查表评估偏倚风险。随机效应荟萃分析按测量工具、年龄组和世卫组织地区对采用相对同质研究方法的研究子集进行。

根据世卫组织官方区域命名法，研究组从57项研究中获得了113个国家或地区的患病率数据。77个国家或地区的青少年（12-17岁）、30个国家的年轻人（18-29岁）、32个国家的中年人（30-59岁）和40个国家的老年人（≥60岁）的数据可用。除青少年外，欧洲以外的所有年龄组都缺乏数据。总体而言，荟萃分析包括24项研究中106个国家的212项估计。

青少年孤独感的总患病率从东南亚的9.2%到东地中海地区的14.4%不等。对于成年人，荟萃分析仅针对欧洲地区进行，所有成人年龄组均显示出一致的地理模式。北欧国家的孤独感患病率最低（年轻人为2.9%，中年人为2.7%，老年人为5.2%），东欧国家最高（年轻人为7.5%、中年人为9.6%、老年人为21.3%）。

研究结果表明，在许多国家，相当一部分人口都经历过有问题的孤独感。高收入国家（尤其是欧洲）与中低收入国家之间的数据覆盖率存在巨大差异，这引发了一个重要的公平问题。关于孤独感的时间趋势的证据还不够充分。这项荟萃分析的结果受到数据稀缺性和方法异质性的限制。研究组呼吁使用标准化和经验证的测量工具，将孤独纳入更广泛的地理和年龄覆盖范围的一般健康监测。

附：英文原文

Title: The prevalence of loneliness across 113 countries: systematic review and meta-analysis

Author: Daniel L Surkalim, Mengyun Luo, Robert Eres, Klaus Gebel, Joseph van Buskirk, Adrian Bauman, Ding Ding

Issue&Volume: 2022/02/09

Abstract:

Objectives To identify data availability, gaps, and patterns for population level prevalence of loneliness globally, to summarise prevalence estimates within World Health Organization regions when feasible through meta-analysis, and to examine temporal trends of loneliness in countries where data exist.

Design Systematic review and meta-analysis.

Data sources Embase, Medline, PsycINFO, and Scopus for peer reviewed literature, and Google Scholar and Open Grey for grey literature, supplemented by backward reference searching (to 1 September 2021)

Eligibility criteria for selecting studies Observational studies based on nationally representative samples (n≥292), validated instruments, and prevalence data for 2000-19. Two researchers independently extracted data and assessed the risk of bias using the Joanna Briggs Institute checklist. Random effects meta-analysis was conducted in the subset of studies with relatively homogeneous research methods by measurement instrument, age group, and WHO region.

Results Prevalence data were available for 113 countries or territories, according to official WHO nomenclature for regions, from 57 studies. Data were available for adolescents (12-17 years) in 77 countries or territories, young adults (18-29 years) in 30 countries, middle aged adults (30-59 years) in 32 countries, and older adults (≥60 years) in 40 countries. Data for all age groups except adolescents were lacking outside of Europe. Overall, 212 estimates for 106 countries from 24 studies were included in meta-analyses. The pooled prevalence of loneliness for adolescents ranged from 9.2% (95% confidence interval 6.8% to 12.4%) in South-East Asia to 14.4% (12.2% to 17.1%) in the Eastern Mediterranean region. For adults, meta-analysis was conducted for the European region only, and a consistent geographical pattern was shown for all adult age groups. The lowest prevalence of loneliness was consistently observed in northern European countries (2.9%, 1.8% to 4.5% for young adults; 2.7%, 2.4% to 3.0% for middle aged adults; and 5.2%, 4.2% to 6.5% for older adults) and the highest in eastern European countries (7.5%, 5.9% to 9.4% for young adults; 9.6%, 7.7% to 12.0% for middle aged adults; and 21.3%, 18.7% to 24.2% for older adults).

Conclusion Problematic levels of loneliness are experienced by a substantial proportion of the population in many countries. The substantial difference in data coverage between high income countries (particularly Europe) and low and middle income countries raised an important equity issue. Evidence on the temporal trends of loneliness is insufficient. The findings of this meta-analysis are limited by data scarcity and methodological heterogeneity. Loneliness should be incorporated into general health surveillance with broader geographical and age coverage, using standardised and validated measurement tools.

DOI: 10.1136/bmj-2021-067068

Source: https://www.bmj.com/content/376/bmj-2021-067068

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