Loneliness, depression, and generalized anxiety across eight countries

BACKGROUND: Loneliness is increasingly recognized as a global public health concern linked to adverse mental health outcomes. However, cross-national evidence on its distribution and association with depression and generalized anxiety is limited. METHODS: We analyzed data from the 2023-2024 Global Social Determinants of Health Survey, a cross-sectional, nationally representative survey of 7,997 adults across Brazil, France, India, Indonesia, Nigeria, the Philippines, Türkiye, and the United States. Depression and generalized anxiety were measured using PHQ-9 and GAD-7 screening tools, respectively, while loneliness was self-reported. Weighted bivariate and multivariate (logistic and Poisson regression) models were used to estimate associations between loneliness and mental health outcomes, adjusting for demographic factors. FINDINGS: Overall, 38.9% of respondents reported loneliness, 9.2% met criteria for depression, and 5.5% for generalized anxiety. Loneliness was more common among younger adults, women, individuals with lower income or education, unmarried individuals, and urban residents. In fully adjusted models, loneliness was associated with depression (OR 2.82 [95% CI: 2.25-3.54]) and generalized anxiety (OR 3.89 [95% CI 2.86-5.28]). INTERPRETATION: Loneliness is common and strongly associated with depression and generalized anxiety across diverse settings. These findings underscore the importance of integrating strategies that promote social connection into mental health policy and interventions. Future research should explore causal pathways.