Karl Heinz Ladwig is Professor of Psychosomatic Medicine and Psychological Medicine at the Medical Faculty of the Technical University of Munich (TUM) and is affiliated to the Department of Psycho-somatic Medicine and Psychotherapy. http://www.psychosomatik.mri.tum.de He is also Head of the Mental Health Epidemiology Unit of the Institute of Epidemiology at the Helmholtz Zentrum Muenchen, German Research Centre for Environmental Health in Munich. As clinical epidemiologist, he coordinates the mental health issues of the Institute. Major research topics of KH Ladwig comprise mental health related stress research in psycho-diabetology, psycho-cardiology (bio-behavioural concepts in cardiology) – both in risk factor epidemiology and clinical research – aging research and psycho-traumatology. His group contributes since a long time research findings by elucidating epidemiological, clinical and basic findings to better understand the impact social support, isolation and loneliness on health.

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Proximity and connectedness are basic requirements of mankind. Remarkable, in modern societies, despite high population density in metropolitan areas the number of people living alone seems to increase steadily. This is particular true for older people, however, over the total life span vulnerable phases can be identified which increase the risk of social isolation. Large scale prospective population based studies in many sites all over the industrialized world have evidenced that sustained feelings of social isolation and loneliness subsequently impact severely mental health but also somatic health of its victims.Particularly, this has been shown for cardio-vascular and metabolic diseases. Theses strong associations require medical explanations. We will give a condensed overview about the state of the art in psycho-(neuro)-physiology and will demonstrate why such adverse emotions of loneliness impact our health so deeply. Here, an impaired HPA axis and dysfunctions of the immune system play a most prominent role. We will not end without trying to draw conclusions of the actual basic research findings for supporting and treating these subjects at risk.