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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 5/2020

01-05-2020 | Suicide | Original Paper

Social connectedness, depression symptoms, and health service utilization: a longitudinal study of Veterans Health Administration patients

Authors: Jason I. Chen, Elizabeth R. Hooker, Meike Niederhausen, Heather E. Marsh, Somnath Saha, Steven K. Dobscha, Alan R. Teo

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 5/2020

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Abstract

Purpose

Our study explored whether aspects of veterans’ social connectedness (social support, interpersonal conflict, loneliness, social norms, number of confidants) are associated with change in their depression symptoms and health services utilization over 1 year.

Methods

We conducted a prospective, longitudinal study of 262 military veterans who obtained primary care and other services at a Veterans Health Administration (VHA) facility and screened positive for depression. Participants completed surveys at baseline and 12-month follow-up. We measured social connectedness variables using the NIH Toolbox Adult Social Relationship Scales. We used the Patient Health Questionnaire to assess depression symptoms and suicidal ideation and administrative medical record data for health services utilization. We calculated change scores to model outcomes over time using multivariable regressions.

Results

We found that higher levels of baseline loneliness were associated with decreased depression severity over 1 year (B = − 1.55, 95% CI [− 2.53, − .56], p < .01). We found a similar association for suicidal ideation. In contrast, higher baseline number of confidants was associated with increased depression (B = .55, 95% CI [.18, .92], p < .01). Higher levels of emotional support were associated with decreased mental health visits (B = − 3.88, 95% CI [− 6.80, − .96], p < .01). No significant associations were found between social connectedness variables and primary care visits.

Conclusions

Emotional support may play an important role in reducing mental health treatment utilization among VHA-using veterans. Additional investigation as to how and why loneliness and number of confidants might be paradoxically associated with depression symptoms remains necessary.
Appendix
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Metadata
Title
Social connectedness, depression symptoms, and health service utilization: a longitudinal study of Veterans Health Administration patients
Authors
Jason I. Chen
Elizabeth R. Hooker
Meike Niederhausen
Heather E. Marsh
Somnath Saha
Steven K. Dobscha
Alan R. Teo
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 5/2020
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-019-01785-9

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