Loneliness is a prevalent and serious public health problem impacting health, well-being and longevity. Seeking to develop effective interventions, researchers at University of California San Diego School of Medicine examined the psychological and environmental factors that lead to patterns of loneliness in different age groups.

Researchers used a web-based survey of 2,843 participants, ages 20 to 69 years, from across the United States.

The study, published in the November edition of the Journal of Clinical Psychiatry, found that levels of loneliness were highest in the 20s and lowest in the 60s, with another peak in the mid-40s.

“What we found was a range of predictors of loneliness across the lifespan,” said corresponding senior author Dilip V. Jeste, MD, senior associate dean for Healthy Aging and Distinguished Professor of Psychiatry and Neurosciences at UC San Diego School of Medicine.

The researchers noted that lower levels of empathy and compassion, smaller social networks, not having a spouse or a partner and greater sleep disturbances were consistent predictors of loneliness across all decades. Lower social self-efficacy — or the ability to reflect confidence in exerting control over one’s own motivation, behavior and social environment — and higher anxiety were associated with worse loneliness in all age decades, except the 60s.

Loneliness was also associated with a lower level of decisiveness in the 50s.

The study confirmed previous reports of a strong inverse association between loneliness and wisdom, especially the pro-social behaviors component (empathy and compassion).

“Compassion seems to reduce the level of loneliness at all ages, probably by enabling individuals to accurately perceive and interpret others’ emotions along with helpful behavior toward others, and thereby increasing their own social self-efficacy and social networks,” said Jeste.

The survey suggested that people in their 20s were dealing with high stress and pressure while trying to establish a career and find a life partner.

“A lot of people in this decade are also constantly comparing themselves on social media and are concerned about how many likes and followers they have,” said Tanya Nguyen, PhD, first author of the study and assistant clinical professor in the Department of Psychiatry at UC San Diego School of Medicine. “The lower level of self-efficacy may lead to greater loneliness.”

People in their 40s start to experience physical challenges and health issues, such as high blood pressure and diabetes.

“Individuals may start to lose loved ones close to them and their children are growing up and are becoming more independent. This greatly impacts self-purpose and may cause a shift in self-identify, resulting in increased loneliness,” said Nguyen.

Jeste said the findings are especially relevant during the COVID-19 global pandemic.

“We want to understand what strategies may be effective in reducing loneliness during this challenging time,” said Jeste. “Loneliness is worsened by the physical distancing that is necessary to stop the spread of the pandemic.”

Nguyen said intervention and prevention efforts should consider stage-of-life issues. “There is a need for a personalized and nuanced prioritizing of prevention targets in different groups of people,” said Jeste.

Co-authors include: Ellen Lee, Rebecca Daly, Tsung-Chin Wu, Yi Tang, Xin Tu, Ryan Van Patten, and Barton Palmer, all at UC San Diego.

Women who experience sexual violence combined with other forms of intimate partner violence suffer greater damage to their health and are much more likely to attempt suicide, according to a study led by researchers at the University of Bristol’s Centre for Academic Primary Care published in the International Journal of Epidemiology .

Intimate partner violence – psychological, physical or sexual violence perpetrated by a current or former partner – is the most common form of violence experienced by women worldwide.

The study (titled ‘Categories and health impacts of intimate partner violence in the World Health Organization (WHO) multi-country study on women’s health and domestic violence’), conducted in collaboration with the World Health Organization (WHO) and University of Melbourne, found that all types of intimate partner violence were associated with long-lasting damage to health but combinations that included sexual violence were more common and markedly more damaging to women’s physical and mental health.

Researchers analyzed data from the WHO multi-country study on women’s health, which has information from 16 different sites in 11 different countries on over 21,000 women who have ever had a partner. This new analysis assessed different combinations of psychological, physical and sexual intimate partner violence and their impacts on health.

They found that over 15% of ever-partnered women had experienced a combination of intimate partner violence that included sexual violence. Those who had experienced this in the last year were ten times more likely to attempt suicide than those who had not.

Women who had experienced multiple forms of abuse were also more likely to experience difficulty walking, difficulty with daily activities, pain or discomfort, poor memory or concentration, dizziness, and vaginal discharge, and to be taking sleeping pills or painkillers.

All types of intimate partner violence were associated with long-lasting damage to health but combinations that included sexual violence were more common and markedly more damaging to women’s physical and mental health.

Study lead, Dr Lucy Potter a GP and NIHR In-Practice Clinical Research Fellow at the University of Bristol’s Centre for Academic Primary Care, said: “We know intimate partner violence is damaging to health. What this study adds is the recognition of the profound harm caused by multiple forms of abuse, particularly when it includes sexual violence, and how we do not see this when all forms of abuse are lumped together as one experience. Practitioners and policy makers must appreciate the diversity of experience of intimate partner violence to tailor support appropriately.

“We also found that these health impacts persist over a year after the abuse ends. So, effective prevention and early intervention are vital to the health of individuals and families and health systems.”

Senior author, Professor Gene Feder from the University of Bristol’s Centre for Academic Primary Care, said: “Violence against women is a violation of human rights that damages their and their children’s physical and mental health, with substantial health care and societal costs. It is an important cause of ill health among women globally and an indicator for Goal 5 – Gender Equality and Women and Girls’ Empowerment – of the United Nations’ Sustainable Development Goals.

“This study, analyzing the impact of different types and combinations of intimate partner violence, shows the severe health impact when these include sexual or psychological abuse. These types of abuse are often not recognized by health care providers.”

Women who had experienced multiple forms of abuse were also more likely to experience difficulty walking, difficulty with daily activities, pain or discomfort, poor memory or concentration, dizziness, and vaginal discharge, and to be taking sleeping pills or painkillers.

Intimate partner violence is a big issue in the LGBTQIA community.

In 2018, for instance, nearly half of men in same-sex couples suffered some form of abuse at the hands of their partner, according to a study that surveyed 320 men (160 male couples) in Atlanta, Boston and Chicago in the US to measure emotional abuse, controlling behaviors, monitoring of partners, and HIV-related abuse.

Unfortunately, a 2019 study found that domestic and family violence (DFV) and intimate partner violence (IPV) were perceived by community members and professional stakeholders to be a “heterosexual issue that did not easily apply to LGBTQIA relationships.” In particular, many community members held the view that relationships between (LGBTQIA) people could avoid the inherent sexism and patriarchal values of heterosexual, cisgender relationships, and, by implication, avoid DFV/IPV.

LGBTQIA people are almost four times more likely than non-LGBTQIA people to experience violent victimization, which includes rape, sexual assault, and aggravated or simple assault.

This is according to a study by the Williams Institute at UCLA School of Law, which also found that LGBTQIA people are more likely to experience violence both from someone known to the victim and at the hands of a stranger.

For this study (“Victimization rates and traits of sexual and gender minorities in the United States: Results from the National Crime Victimization Survey, 2017”), the researchers analyzed data from the 2017 National Crime Victimization Survey in the US. Written by Andrew Flores, Lynn Langton, Ilan H. Mayer and Adam P. Romero, the study was published in Science Advances.

The results showed that, in 2017, LGBTQIA people experienced 71.1 victimizations per 1,000 people, compared to 19.2 victimizations per 1,000 people for non-LGBTQIA people.

LGBTQIA people are more likely to experience violence both from someone known to the victim and at the hands of a stranger.

“We found that the odds of violent victimization among sexual and gender minorities (SGMs) were almost four times that of non-SGMs,” the researchers stated, adding that the higher rates were noticeable “across nearly all of the violent crime subtypes”.

In a statement, Flores said that it may be worth asking why this is happening. And for him, a “plausible cause is anti-LGBTQIA prejudice at home, work or school, which would make LGBTQIA people particularly vulnerable to victimization in numerous areas of their everyday life.”

Other findings included:

• LGBTQIA people are about six times more likely to experience violence by someone who is known to them and about 2.5 times more likely to undergo it at the hands of a stranger
• LBTQIA women are five times more likely than non-LBTQIA women to experience violent victimization
• The risk of violence for GBT men is more than twice that of non-GBT men
• About half of all victimizations are not reported to police.

For Meyer, the study’s findings “point to the importance of policies and interventions to reduce victimization and the need to consider the unique susceptibility to violence and the high rates of crime experienced by LGBTQIA people.”

For many years, lesbian, gay, bisexual, and other non-heterosexual (LGB+) folks have been known to be more likely to smoke than their straight counterparts. But a new, first-of-its-kind Boston University School of Public Health (BUSPH) study paints a more precise picture by looking at LGB+ identities separately and over time, finding that bisexuality is the identity most associated with smoking, especially around the time of coming out.

Published in the journal JAMA Pediatrics, the nationally-representative cohort study followed 7,843 youth and young adults over three years, finding that those who came out as bisexual were twice as likely as consistently-heterosexual participants to start smoking. Coming out as lesbian, gay, or another non-heterosexual identity, or having a consistent LG+ identity, was not associated with being more likely to smoke.

Bisexual young people may face unique forms of discrimination and stigma that increase their risk for smoking or other substance use behaviors.

The study “highlights the importance of moving beyond static measures of sexual identity towards more dynamic measures that capture critical periods of vulnerability,” says Dr. Andrew Stokes, assistant professor of global health at BUSPH and the study’s corresponding author.

“This approach turned out to be really important, because it revealed disparities that would have otherwise been missed if we measured identity at one time point, or grouped all LGB+ identities together,” says study lead author Alyssa Harlow, a doctoral candidate at BUSPH.

Bisexual young people may face unique forms of discrimination and stigma that increase their risk for smoking or other substance use behaviors, Harlow adds.

“For example, they may experience stigma from heterosexual individuals as well as from within the LGB+ community. There’s also prior research that shows that bisexual populations have worse mental health outcomes than LG+ populations,” Harlow says.

The findings point to a need for public health interventions specifically designed to address the unique needs, experiences, and stressors associated with coming out and identifying as bisexual.

For the study, the researchers used data from the first four waves of the American Population Assessment of Tobacco and Health (PATH) study, which surveyed the same 14-29-year-olds three times between 2013 and 2018. (There were too few transgender respondents in this sample for the researchers to include gender identity in their analysis.) The researchers adjusted for other variables including sex, age, race/ethnicity, education level (for participants over 18) and parents’ education level (for participants under 18), and where participants lived (urban/nonurban, and region of the U.S.).

By the third wave, 14% of the respondents had smoked at some point, and 6% were current smokers. The researchers found that the same sexual identity patterns held true both for having smoked at any point in the study period and for being a current smoker.

The researchers found that, compared to a consistent heterosexual identity, coming out as bisexual was associated with being more than twice as likely to smoke. Participants with LG+ identities in the first wave who shifted to a bisexual identity, or vice versa, were twice as likely to smoke.

On the other hand, participants with a consistent LG+ identity throughout the three waves of the study and participants who started out identifying as heterosexual and came out as LG+ were not more likely to smoke than those with a consistent heterosexual identity–while those with a consistent bisexual identity were slightly more likely to smoke.

The researchers say that the study’s unique approach to LGB+ identities–separated and over time–could provide valuable insights for other issues that disproportionately affect the community, including mental health issues and substance use.

But to make that possible, more national surveys need to ask youth about their sexual orientation and gender identity, says study co-author Dielle Lundberg, a research fellow at BUSPH.

“The PATH study is unique because it asks youth about their sexual orientation and gender identity. Most national surveys do not,” Lundberg says. “We must advocate for better data. Whenever national surveys fail to ask about sexual orientation and gender identity, they are directly contributing to health inequities for LGBTQ+ populations.”

Significantly higher numbers of Generation Z boys and girls are dieting to lose weight, and are likely to overestimate their own weight, finds a new UCL-led study.

The research, published in JAMA Pediatrics, found that girls who are trying to lose weight are also more likely to experience depressive symptoms than in previous years.

In 2015, 42% of 14-year-old girls and boys said they currently were trying to lose weight, compared to 30% in 2005.

Lead author Dr Francesca Solmi (UCL Psychiatry) said: “Our findings show how the way we talk about weight, health and appearance can have profound impacts on young people’s mental health, and efforts to tackle rising obesity rates may have unintended consequences.”

An increase in dieting among young people is concerning because experimental studies found that dieting is generally ineffective in the long term at reducing body weight in adolescents, but can instead have greater impacts on mental health.

“We know, for instance, that dieting is a strong risk factor in the development of eating disorders,” Solmi said.

For this study, the research team reviewed data from 22,503 adolescents in the UK, in three different decades, who are part of different cohort studies: the British Cohort Study (of people born in 1970; data was collected in 1986), the Children of the 90s study (born 1991-92, data collected in 2005), and Millennium Cohort Study (born 2000-02, data collected in 2015).

The adolescents were all asked questions about whether they were, or had been, trying to lose weight, whether they had dieted or exercised to lose weight, whether they perceived themselves to be underweight, about the right weight or overweight (which was compared to their actual height and weight measurements), and they filled out questionnaires that gauged depressive symptoms. The researchers found that in 2015, 44% and 60% of all participants had dieted or exercised to lose weight, respectively, compared to 38% and 7% in 1986.

The researchers say other evidence suggests that engagement in vigorous physical activity has remained relatively stable among adolescents over the past few decades.

Senior author Dr Praveetha Patalay (Centre for Longitudinal Studies and MRC Unit for Lifelong Health & Ageing, UCL) said: “It seems that young people are exercising for different reasons than they did before – more adolescents seem to be thinking of exercise predominantly as a means to lose weight rather than exercising for fun, socialising and feeling healthy. We suspect that recent controversial calls to add ‘exercise-equivalent’ labels on food packaging may exacerbate this.”

While girls have consistently been more likely to diet to lose weight, the researchers found a greater increase over the years among boys, who were also becoming more likely to be trying to gain weight.

Dr Patalay said: “Societal pressures for girls to be thin have been around for decades, but body image pressures on boys may be a more recent trend. Our findings underscore the impact that societal pressures and public health messaging around weight can have on children’s health behaviours, body image and mental health.”

Both girls and boys also became more likely to over-estimate their weight from 1986 to 2005, and even more so by 2015, which the researchers say adds to their concerns that increased efforts to lose weight are not necessarily due to increased obesity rates.

The reported weight-related behaviours and weight misperception were associated with depressive symptoms, and among girls, this relationship was becoming even stronger over the three decades examined in this study. The findings could possibly be part of the explanation for increases in adolescent depressive symptoms that have been observed in recent decades.

Dr Solmi said: “Media portrayals of thinness, the rise of the fitness industry and the advent of social media may all partly explain our results, and public health messaging around calorie restriction and exercise might also be causing unintended harm. Public health campaigns around obesity should consider adverse mental health effects, and ensure they avoid weight stigma. By promoting health and wellbeing, as opposed to focusing on ‘healthy weight’, they could have positive effects on both mental and physical health.”

Weight issues also affect members of the LGBTQIA community.

In 2019, for instance, a study found that Grindr, the most popular dating app for gay, bisexual, two-spirit and queer men, had a negative effect on men’s body image, especially when it came to weight. Aside from the weight stigma, body dissatisfaction stemmed from sexual objectification and appearance comparison. 

Still in 2019, another study found that 44% to 70% of LGBTQ teens reported weight-based teasing from family members, 41% to 57% reported weight-based teasing from peers, and as many as 44% reported weight-based teasing from both family members and peers.

Yet another 2019 study found that Lesbian and bisexual women are at increased risk of being overweight or obese compared to heterosexual women.

Neil (not his real name), who claims to be in his 20s, is an “raw fun orgynizer” (or a person who organizes unprotected orgies/group sex through his Romeo, Grindr and Telegram accounts) from Santa Mesa Heights in Quezon City in Metro Manila. He is first to admit that organizing “gatherings” was affected by Covid-19, with the last pre-lockdown “orgynuman” (or an orgy that also involves a drinking session) held in some hotel in Ortigas on February 15.

But things have been “picking up again”, according to him, with the easing of the lockdown. So far, he already organized a gathering on October 28 in Cavite, and another one is scheduled in November in Sta. Mesa. And so “raunchy raw fun is back.”

The effect of Covid-19 on sexual connections is still under-studied; but at least one research found that despite the Covid-19 (SARS-CoV-2) lockdown restrictions, diagnosis of sexually transmitted infections (STIs), including gonorrhoea, secondary syphilis and mycoplasma genitalium (MG), have increased. This is true – at least – in two main STI centers in Milan, Italy. There, compared were the number of confirmed diagnoses of the most common STIs in patients with symptoms for the period 15 March 2020 to 14 April 2020 following social isolation measures (lockdown) adopted to control the epidemic, with the same period in 2019.

The results revealed that despite a reduction in the total number of attendances by over a third (37%, 233 in 2019 vs 147 in 2020), the number of acute bacterial infections, most associated with men who have sex with men (MSM), increased during the observational period, including secondary syphilis and gonorrhoea.

Cases fell, however, in the non-acute cases, such as genital warts and Molluscum Contagiosum.

The study concluded that the COVID-19 pandemic, despite lockdown and advice on social/physical distancing, did not inhibit risky behaviors and that acute STIs actually increased.

While it is unrealistic to prevent people from having sex, even in this extraordinary pandemic, close contact during sexual intercourse inevitably involves an increased risk of SARS-CoV-2 contagion.The findings show the importance of ongoing screening for STIs and the real benefit of having these types of services open and available during these unprecedented times.

Dr Marco Cusini, La Fondazione IRCCS Ca’ Granda Ospedale Maggiore di Milano Policlinico, Milano, Italy, stated: “It was assumed that the lockdown would reduce the opportunity for sexual encounters and STIs. However, I was surprised by the number of new acute infections diagnosed in this short period of time. Gonhorrhea and syphillis are typically more prevalent in people in their 30s, so infection may have increased because the concentration of COVID-19 morbidity and mortality in the elderly made the younger, more active, cohort feel protected and so less risk averse. While it is unrealistic to prevent people from having sex, even in this extraordinary pandemic, close contact during sexual intercourse inevitably involves an increased risk of SARS-CoV-2 contagion.The findings show the importance of ongoing screening for STIs and the real benefit of having these types of services open and available during these unprecedented times.”

While gonorrhoea is still highly susceptible to the mainstay antibiotic treatment option ceftriaxone, the emergence of antimicrobial resistant gonorrhoea remains of concern. Recommended combinations with antibiotics such as azithromycin should be avoided in the light of antibiotic stewardship, necessitating new treatment guidelines. Dr Henry J.C. de Vries of the STI outpatient clinic Health Service Amsterdam presented on The threat of antimicrobial resistant gonorrhoea at 12:00-12:15 CET on Thursday 29th October 2020.

Gonorrhoea is caused by the bacterium Nesisseria gonorrhoeae. Often, but not always, it presents no symptoms in females and is mostly symptomatic in males. Common symptoms in men include urethral discharge and pain upon urination (dysuria), and women may present with odorless vaginal discharge, dysuria and pain during sexual intercourse. Symptoms usually appear between 1-10 days after infection.

Gonorrhoea is on the rise across Europe, in 2017 alone, there were more than 89,000 confirmed cases (240 per day), of which MSM accounted for almost half of all the cases (47%). The UK reported 55% of all cases (75 per 100,000) followed by Ireland (47), Denmark (33), Iceland (29), Norway (27) and Sweden (25).

The first symptoms of syphilis usually develop around 2 or 3 weeks after infection, although they can start later than this. The main symptom is a small, painless sore or ulcer typically on the penis, vagina, or around the anus, although it can sometimes appear in the mouth or on the lips, fingers or buttocks. Secondary syphilis is a progression of the disease and symptoms, however is curable with treatment. In 2018, there were 33,927 confirmed cases in Europe. The highest rate was observed in Malta (17.9 cases per 100,000 population), followed by Luxembourg (17.1), the UK (12.6) and Spain (10.3).

The Milan study may provide a more scientific look at the sexual engagements at the time of Covid-19. But in the Philippines, access to sexual health services have been – and continue to be – hampered by Covid-19. So that the participants in the gatherings of those organized by the likes of Neil are not monitored. And yet checking those commenting on his Telegram GC (group chat), for instance, one would only see the focus on “fun”, not the “risks.”