Department of Psychiatry and Addiction, ASL Roma 5, Colleferro, Rome, Italy.
Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti-Pescara, Italy.
J Affect Disord. 2024 Jan 15;345:358-368. doi: 10.1016/j.jad.2023.10.112. Epub 2023 Oct 16.
Depression affects approximately 4 % of the global population and has huge social and economic implications. Social factors, including support, engagement, and stigma, play a crucial role in the development and severity of depression.
We provide a synthesis of the consistency and magnitude of the association between measures of social connection and depression. We searched PubMed, PsycINFO, Cochrane Library, and EMBASE and 47 meta-analyses were included in the umbrella review. The strength of the associations was extracted and compared among different populations. The quality/certainty of evidence was assessed using AMSTAR-2 and GRADE tool.
Results indicate that social support serves as a protective factor against depression, particularly in peripartum populations, while its impact is weaker in clinical populations. No association was found between social support and depression in post-disaster populations. Stigma and discrimination favour the development and maintenance of depressive symptoms in clinical populations, but have a weaker effect in ethnic minorities.
The quality and certainty of evidence should be taken into account when interpreting our findings. Further research with more rigorous methodology and higher-quality evidence is needed to better understand the complex relationship between depression and social connection across various populations and contexts.
Our findings confirm the role of social determinants in the emergence and severity of depression, particularly in the case of vulnerable populations. Efforts to counteract disconnection at the societal and individual levels and to reduce stigma should be central to an effective depression prevention agenda.
抑郁症影响着全球约 4%的人口，对社会和经济都有着重大影响。社会因素，包括支持、参与和耻辱感，在抑郁症的发展和严重程度中起着至关重要的作用。
我们综合了社会联系措施与抑郁症之间关联的一致性和强度。我们检索了 PubMed、PsycINFO、Cochrane 图书馆和 EMBASE，并纳入了 47 项荟萃分析进行综述。提取关联强度并比较不同人群中的差异。使用 AMSTAR-2 和 GRADE 工具评估证据的质量/确定性。
结果表明，社会支持是预防抑郁症的保护因素，特别是在围产期人群中，而在临床人群中的影响较弱。在灾后人群中，社会支持与抑郁症之间没有关联。耻辱感和歧视有利于临床人群中抑郁症状的发展和维持，但在少数民族中影响较弱。
在解释我们的发现时，应考虑证据的质量和确定性。需要进一步开展具有更严格方法和更高质量证据的研究，以更好地理解不同人群和环境中抑郁症与社会联系之间的复杂关系。
我们的研究结果证实了社会决定因素在抑郁症的发生和严重程度中的作用，特别是在弱势群体中。在社会和个人层面上努力消除脱节并减少耻辱感，应成为有效预防抑郁症议程的核心。
