[Loneliness and its association with sociodemographic and health indicators in Brazilian adults and older adults: ELSI-Brazil]

This study aimed to investigate the prevalence of loneliness and its associations with sociodemographic and health indicators in a nationally representative sample of Brazilian adults and older adults. Data from the baseline (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed, and participants with complete information on the variables of interest (n = 7,957) were included. Loneliness was the outcome variable, which was based on the question "How often do you feel alone or lonely: always, sometimes, or never?" Independent variables included sociodemographic indicators and health behaviors and conditions. The analyses included the Pearson's chi-square test for calculating relative frequencies, and Poisson regression for estimating prevalence ratios (PR) and their respective 95% confidence intervals (95%CI). The prevalence of always feeling lonely was 16.8%; sometimes, 31.7%; and never, 51.5%. Significant associations were observed between always feeling lonely and depression (PR = 4.49; 95%CI: 3.93-5.11), living alone (PR = 2.44; 95%CI: 2.12-2.82), low education level (PR = 1.93; 95%CI: 1.61-2.32), being a woman (PR = 1.53; 95%CI: 1.36-1.72), self-rated poor/very poor health (PR = 1.48; 95%CI: 1.27-1.73), and poor/very poor sleep quality (PR = 1.21; 95%CI: 1.05-1.41). Given its potential to harm quality of life, it is necessary to longitudinally understand the trajectories of loneliness and associated variables, and to use this knowledge to design public policies and health interventions that could benefit the biopsychosocial well-being of Brazilian adults and older adults.

¿Cuáles son las brechas de conocimiento y qué priorizar en investigación en salud mental del adulto mayor? Estudio cuali-cuantitativo utilizando la matriz de estrategias combinadas para Argentina (MECA)

INTRODUCCIÓN

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.

OBJETIVO

identificar brechas de conocimiento y prioridades de investigación en salud mental del adulto mayor en Argentina.

MATERIAL Y MÉTODOS

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).

RESULTADOS

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.

CONCLUSIÓN

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.

Differential impact of stay-at-home orders on mental health in adults who are homeschooling or "childless at home" in time of COVID-19

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.

Mastery and Marital Processes: Mechanisms Linking Midlife Economic Adversity and Later-Life Loneliness for Husbands and Wives in Enduring Marriages

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.

COVID-19, precarity and loneliness

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.