In-Person, Not Online, Contact May Help Vets’ Mental Health

December 4, 2018

More frequent in-person social interaction is linked with a significantly lower risk of symptoms of major depression and posttraumatic stress disorder (PTSD) in US military veterans, according to a study published online in the Journal of Affective Disorders.

Researchers reached the finding after conducting an online survey of 587 veterans who served after September 2001 and who used Facebook. The study aimed to determine whether social media interactions are similar to face-to-face interactions in their association with better mental health.

Participants who used Facebook frequently tended to engage more frequently in face-to-face interactions, researchers found. However, the social media interaction did not appear to affect mental health either way.

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“Although veterans who frequently use Facebook are also typically social in their offline life, it is their offline (in-person) social interaction, rather than their social contact on Facebook, that is associated with reduced psychiatric symptoms,” researchers reported.

In-person contact several times per week was linked with a 50% reduced risk for symptoms of major depression and PTSD, compared with infrequent contact, the study found. Participants’ risk for alcohol use disorder or suicidality was unaffected by in-person or Facebook interaction frequency.

     Alan Teo, MD

Researchers pointed out that the direction of the link between in-person social connection and mental health is unclear. They also emphasized that the study contradicts a common assumption that frequent Facebook use is associated with less frequent in-person contact. Among participants who used Facebook daily, more than one-third saw family or friends face-to-face several times daily, compared with just 19% of more infrequent Facebook users.

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Still, health care professionals should not lose sight of the importance of in-person contact for patients.

“I think the excitement in the [US Department of Veterans Affairs] and other health systems about the opportunities associated with online interventions is great,” said study lead author Alan Teo, MD, VA Portland Health Care System and an assistant professor at Oregon Health & Science University. “But at the same time, this study is a bit of a reminder that the foundation to good mental health care probably starts with promoting good, old-fashioned social connections.”

—Jolynn Tumolo


Teo AR, Chan BK, Saha S, Nicolaidis C. Frequency of social contact in-person vs. on Facebook: an examination of associations with psychiatric symptoms in military veterans. Journal of Affective Disorders. 2018 September 17;[Epub ahead of print].

Horrom T. Study: in-person, but not online, social contact may protect against psychiatric disorders [press release]. Washington, DC: US Department of Veterans Affairs; November 15, 2018.