This systematic overview highlights that there is consistent evidence linking social isolation and loneliness to worse cardiovascular and mental health outcomes. The role of social isolation and loneliness in other conditions and their socio-economic consequences is less clear. More research is needed on associations with cancer, health behaviours, and the impact across the life course and wider socio-economic consequences. Policy makers and health and local government commissioners should consider social isolation and loneliness as important upstream factors impacting on morbidity and mortality due to their effects on cardiovascular and mental health. Prevention strategies should therefore be developed across the public and voluntary sectors, using an asset-based approach.
There is a high prevalence of anxiety and depression in offender populations but with no recent systematic review of interventions to identify what is effective. This systematic review was undertaken to identify randomised controlled trials of pharmacological and non-pharmacological interventions in adult offenders in prison or community settings. A search of five databases identified 14 studies meeting inclusion criteria, which considered the impact of psychological interventions, pharmacological agents, or exercise on levels of depression and anxiety. A narrative synthesis was undertaken and Hedges g effect sizes calculated to allow comparison between studies. Effect sizes for depression interventions ranged from 0.17 to 1.41, for anxiety 0.61 to 0.71 and for posttraumatic stress disorder 0 to 1.41. Cognitive behavioural therapy interventions for the reduction of depression and anxiety in adult offenders appear effective in the short term, though a large-scale trial of sufficient duration is needed to confirm this finding.
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