Loneliness and All-Cause, Cardiovascular, and Noncardiovascular Mortality in Older Men: The Zutphen Elderly Study.

OBJECTIVE: Loneliness, defined as the discrepancy between one's desired and actual relationships, is prevalent in the elderly and can be both emotional and social loneliness. We aimed to determine whether loneliness is independently related to higher all-cause, cardiovascular, and noncardiovascular mortality in elderly men. METHODS: Using a population-based cohort study with 25 years of follow-up from 1985, the Zutphen Study, 719 of 939 men (76.2%; age range: 64-84 years) who had complete data on loneliness at baseline and at least 2 years of survival were studied. Loneliness was assessed using a validated 11-item questionnaire in 1985, 1990, 1995, and 2000. Time-dependent Cox proportional hazards models were adjusted for sociodemographic characteristics and cardiovascular risk factors. RESULTS: At baseline, point prevalence of moderate and severe loneliness was, respectively, 38.8% (N = 279) and 3.2% (N = 23). Loneliness, especially emotional loneliness, did significantly increase over 15 years with an overall reliability coefficient of 0.50. All-cause, cardiovascular, and noncardiovascular mortality were not higher among moderately lonely participants (hazard ratio [HR]: 1.00; 95% confidence interval [CI]: 0.84-1.17; HR: 0.99; 95% CI: 0.78-1.25; and HR: 0.99; 95% CI: 0.79-1.24, respectively) and severely lonely participants (HR: 1.40; 95% CI: 0.85-2.31; HR: 1.18; 95% CI: 0.58-2.39; and HR: 1.63; 95% CIH 0.80-3.31, respectively). CONCLUSION: Loneliness is common and increases during aging, due to the increase in its component emotional loneliness over time. No independent associations with risks of all-cause, cardiovascular, and noncardiovascular death were found.

Musicians seeking psychiatric help: a preliminary study of psychiatric characteristics.

Musicians are at increased risk for mental disorders, in particular performance anxiety. Likely causes are high levels of occupational stress, special personality traits, and coping skills. In this cross-sectional study, routine outcome monitoring (ROM) data on clinical and psychosocial characteristics were collected from the first 50 musicians visiting our outpatient psychiatric clinic for performing artists and were compared to those of a large sample of psychiatric outpatients (n=1,498) and subjects from the general population. Of the musician outpatients, 82% (n=41) met the criteria of an Axis I psychiatric disorder. Performance anxiety could not be accurately diagnosed with the MINI-plus, and in a few cases it masked different psychiatric disorders. Musician outpatients scored significantly better on functional scales despite their Axis I disorder, with equal scores on scales measuring distress compared to general outpatients. Musicians displayed significantly higher mean scores on the DAPP-sf subscale measuring narcissistic personality traits than general outpatients and non-patient controls (p=0.001). Diagnostic challenges, in particular regarding performance anxiety, of musicians seeking psychiatric care are thoroughly discussed. Musicians with psychiatric disorders may constitute a group of patients with specific characteristics who may benefit from specialized psychiatric care, and health professionals should be aware of the high prevalence of psychiatric disorders in musicians.