Social isolation has long been postulated as a major risk factor for depression. Support received from social contacts is believed to buffer against the effects of depression .Clinical implication of social networks to improve the mental well-being of the general populations has only been subjected to research recently, and most of these studies are small and have limited generalisability.
Lindsey E McKenzie, Ram N Polur, Cholrelia Wesley, Jessica D Allen, Robert E McKeown and Jian Zhang report results of US national survey (National Health and Nutrition Examination Survey ) examining whether social contact (church visitation, marital status and the number of close friends ) is a protective factor against depression .They were able to control confounding effects from social deprivation, lifestyle and history of major medical illness. Social contacts were assessed using the Social Support Questionnaire (SSQ) and Depression was assessed using the Patient Health Questionnaire (PHQ).
1. Being currently married was significantly associated with low odds of depression compared with never or previously married; this association was much more salient among men.
2. Lowest prevalence of depression occurred in those with 10 or more close friends, and the highest was seen among those who self-reported no close friends .After adjustment for covariates, the linear association became much weaker among women, but remained pronounced for men.
3.More church attendance was associated with less depression. When adjusted for covariates, this association was still significant among men only.
Traditional social contacts, through friendships, religious activity and marriage, remain strongly associated with a reduced risk of depression, and these relationships are more salient among men compared with women.
a.Cross-sectional design,hence not able to ascertain the directionality of the association b. information on ‘structural position’ of individuals in a social network ( shown to be related depression) was not available c. data on closeness, quality of emotional supports were not collected d. Of the initial cohort of 10,000 adults ,5700 only had all relevant data for analysis.
Comment: Population level interventions are relevant in depression.
McKenzie LE, Polur RN, Wesley C, Allen JD, McKeown RE, Zhang J. Int J Soc Psychiatry. 2013 Nov;59(7):627-35