Loneliness is a major risk factor for both psychological disturbance and poor health outcomes in adults. This study aimed to assess whether childhood loneliness is associated with a long-term disruption in mental health that extends into adulthood.

This study is based on the longitudinal, community-representative Great Smoky Mountains Study of 1420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to eight times in childhood (ages 9–16; 6674 observations; 1993–2000) for childhood loneliness, associated psychiatric comorbidities and childhood adversities. Participants were followed up four times in adulthood (ages 19, 21, 25, and 30; 4556 observations of 1334 participants; 1999–2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric anxiety, depression, and substance use outcomes.

Both self and parent-reported childhood loneliness were associated with adult self-reported anxiety and depressive outcomes. The associations remained significant when childhood adversities and psychiatric comorbidities were accounted for. There was no evidence for an association of childhood loneliness with adult substance use disorders. More associations were found between childhood loneliness and adult psychiatric symptoms than with adult diagnostic status.

Childhood loneliness is associated with anxiety and depressive disorders in young adults, suggesting that loneliness – even in childhood – might have long-term costs in terms of mental health. This study underscores the importance of intervening early to prevent loneliness and its sequelae over time.

孤独是成年人心理障碍和不良健康结果的主要危险因素。这项研究旨在评估童年的孤独感是否与长期影响成年期的心理健康有关。

本研究基于对 1420 名参与者进行的具有社区代表性的大烟山纵向研究。参与者在童年时期接受了多达八次的结构化儿童和青少年精神病学评估访谈（9-16 岁；6674 次观察；1993-2000 年），评估其童年孤独感、相关精神合并症和童年逆境。参与者在成年后接受了四次随访（19岁、21岁、25岁和30岁；1999年至2015年，对1334名参与者进行了4556次观察），采用结构化的青少年精神病学评估访谈来了解精神焦虑、抑郁和物质使用结果。

自我和父母报告的童年孤独感都与成人自我报告的焦虑和抑郁结果相关。当考虑到童年时期的逆境和精神合并症时，这种关联仍然很显着。没有证据表明童年孤独感与成人药物滥用障碍之间存在关联。与成人诊断状态相比，儿童孤独感与成人精神症状之间存在更多关联。

童年的孤独感与年轻人的焦虑和抑郁症有关，这表明孤独感——即使是在童年时期——也可能会给心理健康带来长期的代价。这项研究强调了早期干预以防止孤独感及其随着时间的推移而产生的后遗症的重要性。