Pain, depression, and fatigue: Loneliness as a longitudinal risk factor

Lisa M. Jaremka, Rebecca R. Andridge, Christopher P. Fagundes, Catherine M. Alfano, Stephen P. Povoski, Adele M. Lipari, Doreen M. Agnese, Mark W. Arnold, William B. Farrar, Lisa D. Yee, William E. Carson, Tanios Bekaii-Saab, Edward W. Martin, Carl R. Schmidt, Janice K. Kiecolt-Glaser

Research output: Contribution to journalArticlepeer-review

138 Scopus citations


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. Method: 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 noncaregiver 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.

Original languageEnglish (US)
Pages (from-to)948-957
Number of pages10
JournalHealth Psychology
Issue number9
StatePublished - Sep 2014


  • Aging
  • Depression
  • Fatigue
  • Loneliness
  • Pain

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Pain, depression, and fatigue: Loneliness as a longitudinal risk factor'. Together they form a unique fingerprint.

Cite this