{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:55:04Z","timestamp":1792198504136,"version":"4.4.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychiatry"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Loneliness has gained increasing attention for its detrimental effects on individuals\u2019 mental and physical health. Anxiety, among other psychiatric conditions, has been associated with loneliness. This study assessed the association between loneliness and generalized anxiety and explored potential social moderators of this relationship. Furthermore, it aimed to identify sociodemographic and social factors associated with loneliness and generalized anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 1084 adults aged\u2009\u2265\u200918 years. Participants completed a sociodemographic and social factors questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the three-item University of California, Los Angeles (UCLA) Loneliness Scale. Bivariate analyses were performed to assess factors associated with loneliness and generalized anxiety. In addition, moderation analyses were conducted to examine potential social factors moderating the association between loneliness and generalized anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The findings revealed that loneliness had a significant positive association with generalized anxiety (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Both the frequency of contact with others and having someone to rely on and discuss problems with moderated this association. Individuals who lived alone; did not have someone to rely on and discuss problems with; had a personal history of psychiatric consultation or medication use; and had less frequent contact with friends, family members, and neighbors exhibited higher mean scores for loneliness and generalized anxiety compared with their counterparts. Furthermore, individuals with chronic disorders exhibited higher mean loneliness scores. Older age was significantly associated with lower generalized anxiety scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings highlight the detrimental effect of loneliness on mental health. Having someone to rely on and discuss problems with, as well as frequent contact with friends, family members, and neighbors, can buffer the negative impact of loneliness on mental health. Therefore, initiating appropriate strategies and public health policies to reduce loneliness and mitigate its negative consequences is necessary. These findings provide valuable insights for future research, particularly in Saudi Arabia, on potential moderators in the relationship between loneliness and anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12888-026-08080-3","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T09:17:25Z","timestamp":1776417445000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Generalized anxiety and loneliness among the general population in Saudi Arabia"],"prefix":"10.1186","volume":"26","author":[{"given":"Rehab","family":"Alhazmi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riyam","family":"Alhazmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"8080_CR1","doi-asserted-by":"publisher","first-page":"1134865","DOI":"10.3389\/fpsyt.2023.1134865","volume":"14","author":"M Ahmed","year":"2023","unstructured":"Ahmed M, Cerda I, Maloof M. Breaking the vicious cycle: The interplay between loneliness, metabolic illness, and mental health. Front Psychiatry. 2023;14:1134865.","journal-title":"Front Psychiatry"},{"key":"8080_CR2","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.puhe.2017.07.035","volume":"152","author":"N Leigh-Hunt","year":"2017","unstructured":"Leigh-Hunt N, Bagguley D, Bash K, Turner V, Turnbull S, Valtorta N, et al. An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health. 2017;152:157\u201371.","journal-title":"Public Health"},{"issue":"1","key":"8080_CR3","first-page":"59","volume":"32","author":"P Tragantzopoulou","year":"2021","unstructured":"Tragantzopoulou P, Giannouli V. Social isolation and loneliness in old age: Exploring their role in mental and physical health. Psychiatriki. 2021;32(1):59\u201366.","journal-title":"Psychiatriki"},{"issue":"1","key":"8080_CR4","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/s12888-017-1262-x","volume":"17","author":"ME Beutel","year":"2017","unstructured":"Beutel ME, Klein EM, Br\u00e4hler E, Reiner I, J\u00fcnger C, Michal M, et al. Loneliness in the general population: Prevalence, determinants and relations to mental health. BMC Psychiatry. 2017;17(1):97.","journal-title":"BMC Psychiatry"},{"issue":"1","key":"8080_CR5","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1186\/s12889-020-09208-0","volume":"20","author":"T Franssen","year":"2020","unstructured":"Franssen T, Stijnen M, Hamers F, Schneider F. Age differences in demographic, social and health-related factors associated with loneliness across the adult life span (19\u201365 years): A cross-sectional study in the Netherlands. BMC Public Health. 2020;20(1):1118.","journal-title":"BMC Public Health"},{"key":"8080_CR6","doi-asserted-by":"publisher","first-page":"105627","DOI":"10.1016\/j.archger.2024.105627","volume":"128","author":"S Susanty","year":"2025","unstructured":"Susanty S, Nadirawati N, Setiawan A, Haroen H, Pebrianti S, Harun H, et al. Overview of the prevalence of loneliness and associated risk factors among older adults across six continents: A meta-analysis. Arch Gerontol Geriatr. 2025;128:105627.","journal-title":"Arch Gerontol Geriatr"},{"issue":"2","key":"8080_CR7","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1007\/s12160-010-9210-8","volume":"40","author":"LC Hawkley","year":"2010","unstructured":"Hawkley LC, Cacioppo JT. Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010;40(2):218\u201327.","journal-title":"Ann Behav Med"},{"issue":"11","key":"8080_CR8","doi-asserted-by":"publisher","first-page":"2161","DOI":"10.1007\/s00127-022-02261-7","volume":"57","author":"F Mann","year":"2022","unstructured":"Mann F, Wang J, Pearce E, Ma R, Schlief M, Lloyd-Evans B, et al. Loneliness and the onset of new mental health problems in the general population. Soc Psychiatry Psychiatr Epidemiol. 2022;57(11):2161\u201378.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"8080_CR9","doi-asserted-by":"publisher","first-page":"116163","DOI":"10.1016\/j.socscimed.2023.116163","volume":"334","author":"M Barjakov\u00e1","year":"2023","unstructured":"Barjakov\u00e1 M, Garnero A, d\u2019Hombres B. Risk factors for loneliness: A literature review. Soc Sci Med. 2023;334:116163.","journal-title":"Soc Sci Med"},{"issue":"4","key":"8080_CR10","doi-asserted-by":"publisher","first-page":"51","DOI":"10.3390\/socsci9040051","volume":"9","author":"KJ MacDonald","year":"2020","unstructured":"MacDonald KJ, Willemsen G, Boomsma DI, Schermer JA. Predicting loneliness from where and what people do. Soc Sci. 2020;9(4):51.","journal-title":"Soc Sci"},{"issue":"4","key":"8080_CR11","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1002\/jad.12046","volume":"94","author":"C Goodfellow","year":"2022","unstructured":"Goodfellow C, Hardoon D, Inchley J, Leyland AH, Qualter P, Simpson SA, et al. Loneliness and personal well-being in young people: Moderating effects of individual, interpersonal, and community factors. J Adolesc. 2022;94(4):554\u201368.","journal-title":"J Adolesc"},{"issue":"2","key":"8080_CR12","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s10433-022-00692-4","volume":"19","author":"L Dahlberg","year":"2022","unstructured":"Dahlberg L, McKee KJ, Lennartsson C, Rehnberg J. A social exclusion perspective on loneliness in older adults in the Nordic countries. Eur J Ageing. 2022;19(2):175\u201388.","journal-title":"Eur J Ageing"},{"issue":"3","key":"8080_CR13","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1007\/s00127-018-1482-5","volume":"53","author":"MH Lim","year":"2018","unstructured":"Lim MH, Gleeson JFM, Alvarez-Jimenez M, Penn DL. Loneliness in psychosis: A systematic review. Soc Psychiatry Psychiatr Epidemiol. 2018;53(3):221\u201338.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"4","key":"8080_CR14","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1177\/1403494821997219","volume":"50","author":"UK Moksnes","year":"2022","unstructured":"Moksnes UK, Bj\u00f8rnsen HN, Eilertsen B, Espnes ME. The role of perceived loneliness and sociodemographic factors in association with subjective mental and physical health and well-being in Norwegian adolescents. Scand J Public Health. 2022;50(4):432\u20139.","journal-title":"Scand J Public Health"},{"issue":"7","key":"8080_CR15","doi-asserted-by":"publisher","first-page":"e088590","DOI":"10.1136\/bmjopen-2024-088590","volume":"15","author":"H Cho","year":"2025","unstructured":"Cho H, Lee J, Heo J, Kang D, Cho J. Association between loneliness and depression, anxiety and anger during the COVID-19 pandemic: A nationwide population-based survey. BMJ Open. 2025;15(7):e088590.","journal-title":"BMJ Open"},{"issue":"10","key":"8080_CR16","doi-asserted-by":"publisher","first-page":"1676","DOI":"10.1093\/geronb\/gbad105","volume":"78","author":"K Van Bogart","year":"2023","unstructured":"Van Bogart K, Scott SB, Harrington KD, Felt JM, Sliwinski MJ, Graham-Engeland JE. Examining the bidirectional nature of loneliness and anxiety among older adults in daily life. J Gerontol B Psychol Sci Soc Sci. 2023;78(10):1676\u201385.","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"issue":"4","key":"8080_CR17","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1177\/17579139211016077","volume":"141","author":"J Christiansen","year":"2021","unstructured":"Christiansen J, Qualter P, Friis K, Pedersen SS, Lund R, Andersen CM, et al. Associations of loneliness and social isolation with physical and mental health among adolescents and young adults. Perspect Public Health. 2021;141(4):226\u201336.","journal-title":"Perspect Public Health"},{"key":"8080_CR18","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.jad.2018.12.043","volume":"246","author":"J Dom\u00e8nech-Abella","year":"2019","unstructured":"Dom\u00e8nech-Abella J, Mund\u00f3 J, Haro JM, Rubio-Valera M. Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from the Irish Longitudinal Study on Ageing (TILDA). J Affect Disord. 2019;246:82\u20138.","journal-title":"J Affect Disord"},{"issue":"4","key":"8080_CR19","doi-asserted-by":"publisher","first-page":"2322","DOI":"10.3390\/ijerph19042322","volume":"19","author":"H Son","year":"2022","unstructured":"Son H, Cho HJ, Cho S, Ryu J, Kim S. The moderating effect of social support between loneliness and depression: Differences between the young-old and the old-old. Int J Environ Res Public Health. 2022;19(4):2322.","journal-title":"Int J Environ Res Public Health"},{"issue":"10","key":"8080_CR20","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","volume":"166","author":"RL Spitzer","year":"2006","unstructured":"Spitzer RL, Kroenke K, Williams JBW, L\u00f6we B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med. 2006;166(10):1092\u20137.","journal-title":"Arch Intern Med"},{"key":"8080_CR21","doi-asserted-by":"publisher","first-page":"1213851","DOI":"10.3389\/fpubh.2023.1213851","volume":"11","author":"AA Alhabeeb","year":"2023","unstructured":"Alhabeeb AA, Al-Duraihem RA, Alasmary S, Alkhamaali Z, Althumiri NA, BinDhim NF. National screening for anxiety and depression in Saudi Arabia 2022. Front Public Health. 2023;11:1213851.","journal-title":"Front Public Health"},{"issue":"1","key":"8080_CR22","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12991-017-0155-1","volume":"16","author":"AN AlHadi","year":"2017","unstructured":"AlHadi AN, AlAteeq DA, Al-Sharif E, Bawazeer HM, Alanazi H, AlShomrani AT, et al. An Arabic translation, reliability, and validation of Patient Health Questionnaire in a Saudi sample. Ann Gen Psychiatry. 2017;16(1):32.","journal-title":"Ann Gen Psychiatry"},{"issue":"9","key":"8080_CR23","doi-asserted-by":"publisher","first-page":"8447","DOI":"10.1007\/s12144-022-02892-8","volume":"43","author":"NK Syed","year":"2022","unstructured":"Syed NK, Alqahtani SS, Meraya AM, Elnaem MH, Albarraq AA, Syed MH, et al. Psychological impact of COVID-19 restrictions among individuals at risk of exercise addiction and their socio-demographic correlates: A Saudi Arabian survey study. Curr Psychol. 2022;43(9):8447\u201362.","journal-title":"Curr Psychol"},{"key":"8080_CR24","volume-title":"Introduction to Mediation, Moderation, and conditional process analysis: A regression-based Approach","author":"AF Hayes","year":"2022","unstructured":"Hayes AF. Introduction to Mediation, Moderation, and conditional process analysis: A regression-based Approach. New York: Guilford; 2022."},{"issue":"5","key":"8080_CR25","first-page":"70","volume":"15","author":"E Ega\u00f1a-Marcos","year":"2025","unstructured":"Ega\u00f1a-Marcos E, Collantes E, Diez-Solinska A, Azkona G. The influence of loneliness, social support and income on mental well-being. Eur J Investig Health Psychol Educ. 2025;15(5):70.","journal-title":"Eur J Investig Health Psychol Educ"},{"issue":"1","key":"8080_CR26","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1186\/s12888-018-1736-5","volume":"18","author":"J Wang","year":"2018","unstructured":"Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: A systematic review. BMC Psychiatry. 2018;18(1):156.","journal-title":"BMC Psychiatry"},{"key":"8080_CR27","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/j.jad.2024.07.112","volume":"362","author":"SM Park","year":"2024","unstructured":"Park SM, Kim DB, Joo MJ, Park EC. Association between living alone and generalized anxiety disorder in Korean adults. J Affect Disord. 2024;362:630\u20137.","journal-title":"J Affect Disord"},{"key":"8080_CR28","doi-asserted-by":"crossref","unstructured":"Al-Khraif R, Abdul Salam A, Abdul Rashid MF. Family demographic transition in Saudi Arabia: emerging issues and concerns. Sage Open. 2020;10(1).","DOI":"10.1177\/2158244020914556"},{"key":"8080_CR29","doi-asserted-by":"crossref","unstructured":"Almalki S, Ganong L. Family life education in Saudi Arabia. In: Robila M, Taylor, AC, editors. Global Perspectives on Family Life Education. Springer International Publishing; 2018. pp. 381\u201396.","DOI":"10.1007\/978-3-319-77589-0_24"},{"key":"8080_CR30","doi-asserted-by":"publisher","first-page":"84","DOI":"10.26758\/10.1.9","volume":"11","author":"K Giannoulis","year":"2020","unstructured":"Giannoulis K, Giannouli V. Religious beliefs, self-esteem, anxiety, and depression among Greek Orthodox elders. J Anthropol Researches Stud. 2020;11:10:84\u201392.","journal-title":"J Anthropol Researches Stud"},{"key":"8080_CR31","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1007\/978-3-031-31986-0_35","volume":"1425","author":"V Giannouli","year":"2023","unstructured":"Giannouli V, Giannoulis K. Better understand to better predict subjective well-being among older Greeks in COVID-19 era: depression, anxiety, attitudes towards eHealth, religiousness, spiritual experience, and cognition. Adv Exp Med Biol. 2023;1425:359\u201364.","journal-title":"Adv Exp Med Biol"},{"key":"8080_CR32","unstructured":"General Authority for Statistics. Saudi Census Statistics. 2022. Kingdom of Saudi Arabia: General Authority for Statistics; 2022[cited 2026 Jan 26]. Available from: https:\/\/www.stats.gov.sa\/en\/statistics?index=119025&subindex=127380"},{"issue":"1","key":"8080_CR33","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1037\/0021-9010.90.1.94","volume":"90","author":"H Aguinis","year":"2005","unstructured":"Aguinis H, Beaty JC, Boik RJ, Pierce CA. Effect size and power in assessing moderating effects of categorical variables using multiple regression: a 30-year review. J Appl Psychol. 2005;90(1):94.","journal-title":"J Appl Psychol"}],"container-title":["BMC Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12888-026-08080-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12888-026-08080-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12888-026-08080-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:16:47Z","timestamp":1781648207000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12888-026-08080-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,17]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8080"],"URL":"https:\/\/doi.org\/10.1186\/s12888-026-08080-3","relation":{},"ISSN":["1471-244X"],"issn-type":[{"value":"1471-244X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,17]]},"assertion":[{"value":"7 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board (IRB) of King Abdullah International Medical Research Center (KAIMRC) with study number (NRR24\/086\/5) and approval number (0000041524). All the participants provided informed consent to participate in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"430"}}