Stoms Madison, Szücs Anna, Wang Yanni, Szanto Katalin, Galfalvy Hanga
Department of Biostatistics, Columbia University, New York, New York.
Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Biol Psychiatry Glob Open Sci. 2025 Apr 21;5(4):100513. doi: 10.1016/j.bpsgos.2025.100513. eCollection 2025 Jul.
Maintaining one's social capital may protect older adults with depression from contemplating suicide, possibly by contributing to overall well-being and mitigating the negative effects of arising difficulties such as worsening mental or physical health. However, it remains unclear whether such protective overall and mitigating effects stem primarily from the size and diversity of one's social network (social connectedness) or from the feeling of being supported by others (perceived social support) and whether these effects persist over time.
In a longitudinal sample of adults with depression ages ≥50 years ( = 287, mean age = 64 years, mean follow-up time = 2 years), with most participants having suicidal ideation ( = 203), zero-inflated negative binomial regression models were used to prospectively evaluate whether social connectedness and perceived social support measured at baseline decreased the presence and severity of suicidal ideation, and whether they moderated the unfavorable effect of baseline depression severity and physical illness on ideation presence and severity at baseline and during short- and long-term follow-ups.
In prospective models, both ideation presence and ideation severity decreased with social connectedness (ideation presence: odds ratio = 0.77, SE = 0.10, = .003; ideation severity: rate ratio [RR] = 0.84, SE = 0.05, = .005). Perceived social support only decreased ideation severity (RR = 0.64, SE = 0.05, < .001). No moderation effect with social health measures reached significance.
Social connectedness and perceived social support confer lasting protection against suicidal ideation. Clinicians should encourage preventive maintenance of diverse social networks in their middle-age and older patients/clients with depression and help them find adequate social support during acute suicidal crises.
维持个人的社会资本可能会保护患有抑郁症的老年人不产生自杀念头，这可能是通过促进整体幸福感以及减轻诸如心理健康或身体健康恶化等出现的困难所带来的负面影响。然而，目前尚不清楚这种保护性的整体和减轻影响主要是源于个人社交网络的规模和多样性（社会联系）还是源于他人支持的感觉（感知到的社会支持），以及这些影响是否会随着时间持续存在。
在一个年龄≥50岁的抑郁症成年纵向样本（n = 287，平均年龄 = 64岁，平均随访时间 = 2年）中，大多数参与者有自杀念头（n = 203），使用零膨胀负二项回归模型前瞻性评估基线时测量的社会联系和感知到的社会支持是否会降低自杀念头的存在和严重程度，以及它们是否会缓和基线抑郁症严重程度和身体疾病对基线时以及短期和长期随访中自杀念头存在和严重程度的不利影响。
在前瞻性模型中，自杀念头的存在和严重程度都随着社会联系而降低（自杀念头的存在：优势比 = 0.77，标准误 = 0.10，P = .003；自杀念头的严重程度：率比[RR] = 0.84，标准误 = 0.05，P = .005）。感知到的社会支持仅降低了自杀念头的严重程度（RR = 0.64，标准误 = 0.05，P < .001）。与社会健康指标的调节效应均未达到显著水平。
社会联系和感知到的社会支持对自杀念头具有持久的保护作用。临床医生应鼓励其患有抑郁症的中年及老年患者/客户预防性地维持多样化的社交网络，并在急性自杀危机期间帮助他们找到足够的社会支持。
