Impact of loneliness on depression among cancer survivors: a comparison between adolescents and young adults and other age groups

Abstract Background Numerous studies have suggested an association between loneliness and depression in cancer survivors, particularly adolescents and young adults (AYAs). This study aimed to develop a causal model linking loneliness to depression using structural equation modeling. Methods A cross-...

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Main Authors: Ken Kurisu, Masako Okamura, Keiko Ozawa, Saki Harashima, Kazuhiro Yoshiuchi, Yosuke Uchitomi, Maiko Fujimori
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14734-4
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author Ken Kurisu
Masako Okamura
Keiko Ozawa
Saki Harashima
Kazuhiro Yoshiuchi
Yosuke Uchitomi
Maiko Fujimori
author_facet Ken Kurisu
Masako Okamura
Keiko Ozawa
Saki Harashima
Kazuhiro Yoshiuchi
Yosuke Uchitomi
Maiko Fujimori
author_sort Ken Kurisu
collection DOAJ
description Abstract Background Numerous studies have suggested an association between loneliness and depression in cancer survivors, particularly adolescents and young adults (AYAs). This study aimed to develop a causal model linking loneliness to depression using structural equation modeling. Methods A cross-sectional web-based survey was conducted to collect demographic information and psychosocial measures, including the UCLA Loneliness Scale, Patient Health Questionnaire-9, EQ-5D-5L, Multidimensional Scale of Perceived Social Support short form, Brief Resilience Scale, Comprehensive Score for Financial Toxicity, and a single item on cancer-related stigma. Structural equation modeling with observed variables was conducted, focusing on the pathway from loneliness to depression. Multiple-group analysis was used to compare AYAs and non-AYAs. Results The study included 3,565 cancer survivors, of whom 743 (20.8%) were AYAs. The final model showed a significant association between loneliness and depression (standardized coefficient = 0.214; 95% confidence interval = 0.184–0.243; P < 0.001). Perceived social support, resilience, financial toxicity, and stigma were directly or indirectly related to loneliness and depression. Female sex and having a spouse or partner were associated with perceived social support, whereas non-job-related social participation was associated with loneliness. The association between loneliness and depression was significantly stronger among AYAs than non-AYAs. Conclusions The results suggested a significant link between loneliness and depression, with a stronger pathway in AYAs. Loneliness may serve as a modifiable mediator for interventions targeting depression prevention among AYA cancer survivors. The psychosocial variables identified could aid in screening high-risk individuals and developing effective interventions.
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spelling doaj-art-e418f0cd13634a469639a9f029fd45092025-08-20T03:47:10ZengBMCBMC Cancer1471-24072025-08-012511810.1186/s12885-025-14734-4Impact of loneliness on depression among cancer survivors: a comparison between adolescents and young adults and other age groupsKen Kurisu0Masako Okamura1Keiko Ozawa2Saki Harashima3Kazuhiro Yoshiuchi4Yosuke Uchitomi5Maiko Fujimori6Department of Cancer Survivorship and Digital Medicine, Jikei University School of MedicineDivision of Survivorship Research, National Cancer Center Institute for Cancer ControlDivision of Survivorship Research, National Cancer Center Institute for Cancer ControlDivision of Survivorship Research, National Cancer Center Institute for Cancer ControlDepartment of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cancer Survivorship and Digital Medicine, Jikei University School of MedicineDivision of Survivorship Research, National Cancer Center Institute for Cancer ControlAbstract Background Numerous studies have suggested an association between loneliness and depression in cancer survivors, particularly adolescents and young adults (AYAs). This study aimed to develop a causal model linking loneliness to depression using structural equation modeling. Methods A cross-sectional web-based survey was conducted to collect demographic information and psychosocial measures, including the UCLA Loneliness Scale, Patient Health Questionnaire-9, EQ-5D-5L, Multidimensional Scale of Perceived Social Support short form, Brief Resilience Scale, Comprehensive Score for Financial Toxicity, and a single item on cancer-related stigma. Structural equation modeling with observed variables was conducted, focusing on the pathway from loneliness to depression. Multiple-group analysis was used to compare AYAs and non-AYAs. Results The study included 3,565 cancer survivors, of whom 743 (20.8%) were AYAs. The final model showed a significant association between loneliness and depression (standardized coefficient = 0.214; 95% confidence interval = 0.184–0.243; P < 0.001). Perceived social support, resilience, financial toxicity, and stigma were directly or indirectly related to loneliness and depression. Female sex and having a spouse or partner were associated with perceived social support, whereas non-job-related social participation was associated with loneliness. The association between loneliness and depression was significantly stronger among AYAs than non-AYAs. Conclusions The results suggested a significant link between loneliness and depression, with a stronger pathway in AYAs. Loneliness may serve as a modifiable mediator for interventions targeting depression prevention among AYA cancer survivors. The psychosocial variables identified could aid in screening high-risk individuals and developing effective interventions.https://doi.org/10.1186/s12885-025-14734-4Adolescents and young adultsCancerLonelinessDepressionStructural equation modeling
spellingShingle Ken Kurisu
Masako Okamura
Keiko Ozawa
Saki Harashima
Kazuhiro Yoshiuchi
Yosuke Uchitomi
Maiko Fujimori
Impact of loneliness on depression among cancer survivors: a comparison between adolescents and young adults and other age groups
BMC Cancer
Adolescents and young adults
Cancer
Loneliness
Depression
Structural equation modeling
title Impact of loneliness on depression among cancer survivors: a comparison between adolescents and young adults and other age groups
title_full Impact of loneliness on depression among cancer survivors: a comparison between adolescents and young adults and other age groups
title_fullStr Impact of loneliness on depression among cancer survivors: a comparison between adolescents and young adults and other age groups
title_full_unstemmed Impact of loneliness on depression among cancer survivors: a comparison between adolescents and young adults and other age groups
title_short Impact of loneliness on depression among cancer survivors: a comparison between adolescents and young adults and other age groups
title_sort impact of loneliness on depression among cancer survivors a comparison between adolescents and young adults and other age groups
topic Adolescents and young adults
Cancer
Loneliness
Depression
Structural equation modeling
url https://doi.org/10.1186/s12885-025-14734-4
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