The associations between loneliness, social exclusion and pain in the general population: A N=502,528 cross-sectional UK Biobank study

• Published in: Journal of psychiatric research Vol. 130; pp. 68 - 74
• Main Authors: Allen, Sarah F., Gilbody, Simon, Atkin, Karl, van der Feltz-Cornelis, Christina
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2020
• Subjects: Biological Specimen Banks; Cross-Sectional Studies; Female; Humans; Loneliness; Male; Middle Aged; Pain; Pain - epidemiology; Public health; Sleep; Social exclusion; Social Isolation; UKBiobank; United Kingdom - epidemiology; United Kingdom; Loneliness; Social exclusion; Pain; Sleep; UKBiobank; Public health
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2020.06.028

Chronic pain presents a huge burden for individuals and society and evidence suggests intrinsic links with loneliness, social exclusion and sleep. Research examining how these factors interact is warranted. We aimed to explore the relationships between social exclusion, loneliness, acute and chronic pain, and the influence of poor sleep, in the general UK population. A cross-sectional analysis of UKBiobank participants with baseline data for acute and chronic pain, loneliness and sleep. Principal components analysis (PCA) used data relating to social isolation and deprivation to establish a composite measure of social exclusion. Binary logistic regression analyses were performed. 502,528 UKBiobank participants (mean age = 56.6years, 54.4%female, 94.6%white) were included in the analysis. PCA suggested three social exclusion factors “social participation”, “individual deprivation” and “area deprivation”. Loneliness significantly predicted acute (OR:1.887; 95%CI1.857–1.917) and chronic pain (OR:1.843; 95%CI1.816–1.870). Each social exclusion factor alone and in combination significantly predicted pain with largest effects for individuals scoring high on all social exclusion factors, for acute (OR:2.087; 95%CI2.026–2.150) and chronic (OR:2.314; 95%CI2.249–2.380) pain. Coefficients remained statistically significant when models were adjusted for demographics and sleep. Social exclusion (as a multifaceted construct) and loneliness are associated with an increased prevalence of acute and chronic pain. Poor sleep has a potential mediating effect on these associations. Exploration of the incidence of pain in loneliness and social exclusion in the general population is warranted. From a public health perspective these findings could be used to design social interventions to prevent or manage pain and mitigate social exclusion. •Chronic pain presents a huge burden for both individuals and society and is a major public health priority.•This study is the first to explore the links between social exclusion, loneliness and pain in the UKBiobank.•Findings show loneliness and social exclusion as a multifaceted construct are linked to an increased prevalence of pain.•These findings could help design novel pain management interventions or social interventions to mitigate social exclusion.