ABSTRACT
Introduction: The coronavirus disease (COVID-19) pandemic led to social isolation and global lockdown, resulting in loneliness and lack of emotional support, which have been associated with adverse mental health outcomes. This study aims to explore the impact of loneliness and emotional support on depression and substance use behavior among young adults and their parents during the COVID-19 pandemic.
Methods: A cohort of 1227 participants was recruited from three ongoing GPEG of NYSPI cohort studies in the metropolitan area of New York City, USA. The participants comprised 530 (43.51%) young adults and 688 (56.49%) parents, with mean ages of 24.47 years and 57.27 years, respectively. The overall mean age was 42.73 years. Logistic regression models were used to analyze data, with adjustments made for age, gender, race, employment status, living conditions, and marital status. Additionally, the effect modification of respondent type and living condition was examined.
Results: At baseline, loneliness showed a significant positive association with depressive symptoms (OR: 2.56, 95%CI: 2.19-3.00, P = 2E-16) and an increase in substance use behavior, such as smoking tobacco using cigarettes, pipes, or cigar (OR: 1.59, 95%CI: 1.24-2.04, P = 0.00030), alcohol consumption (OR: 1.23, 95%CI: 1.07-1.42, P = 0.0030), and marijuana/other substances use (OR: 1.57, 95%CI: 1.26-1.96, P = 6.9E-5). Conversely, emotional support showed a significant negative association with depressive symptoms (OR: 0.71, 95%CI: 0.62-0.81, P = 4.3E-7) but a non-significant association with increased substance use behavior. However, a significant negative association was observed between emotional support and increased tobacco smoking using cigarettes, pipes, or cigar (OR: 0.73, 95%CI: 0.58-0.93, P = 0.011). The effects of loneliness and emotional support on mental health outcomes were stronger in the follow-up study compared to baseline. Age, gender, race, employment status, living conditions, and marital status were adjusted for in the regression models, but their confounding effects were largely non-significant. The modifier effects of age (respondent types) and living condition were also non-significant.
Conclusion: This study indicates that increased loneliness is associated with a higher likelihood of depression and substance use behavior, while higher emotional support is linked to a reduced likelihood of depressive symptoms. However, emotional support may have a minimal impact on substance use behavior.
Keywords: COVID-19; Depression; Emotional support; Loneliness; Substance Use, New York City.