Reciprocal effects of social support in major depression epidemiology.
BACKGROUND
The clinical course and epidemiology of major depressive episodes (MDEs) may be influenced by reciprocal interactions between an individual and the social environment. Epidemiological data concerning these interactions may assist with anticipating the clinical needs of depressed patients.


METHODS
The data source for this study was a Canadian longitudinal study, the National Population Health Survey (NPHS), which provided 8 years of follow-up data. The NPHS interview included a brief diagnostic indicator for MDE, the Composite International Diagnostic Interview Short Form for Major Depression (CIDI-SFMD). The NPHS interview also incorporated the Medical Outcomes Study Social Support Scale (MOSSS) and a set of relevant demographic and health-related measures. The MOSSS assesses total social support and four specific dimensions of social support. Hazard ratios (HR) were used to quantify associations in the longitudinal data.


RESULTS
LOWER QUARTILE TOTAL SOCIAL SUPPORT RATINGS PREDICTED MDE INCIDENCE: the HR adjusted for age and sex was 1.9 (95% CI 1.6 - 2.2). Lower quartile ratings in specific social support dimensions yielded similar HRs. MDE was associated with emergence of lower-quartile affection social support (age and sex adjusted HR 1.3, 95% CI 1.1 - 1.7), but other aspects of social support were not consistently associated with MDE.


CONCLUSIONS
Low social support appears to be a robust risk factor for MDE and can be used to identify persons at higher risk of MDE. Evidence that MDE has a negative effect on social support was weaker and was restricted to affection social support.
Department of Community Health Sciences, Faculty of Medicine, University of Calgary, 3 Floor TRW Building, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6.
Scott B
SB
Patten
Jeanne V A
JV
Williams
Dina H
DH
Lavorato
Andrew G M
AG
Bulloch
J Consult Clin Psychol. 2007 Dec;75(6):888-900
18085906
Br J Psychiatry. 2010 Jan;196(1):13-7
20044653
Health Rep. 1999 Winter;11(3):63-75(Eng); 71-84(Fre)
10779926
Psychol Bull. 1985 Sep;98(2):310-57
3901065
Soc Sci Med. 1991;32(6):705-14
2035047
Chronic Dis Can. 2000;21(2):68-72
11007657
J Affect Disord. 2010 Jun;123(1-3):158-63
19720400
J Abnorm Psychol. 1990 Aug;99(3):264-71
2212276
J Nerv Ment Dis. 2008 Dec;196(12):876-83
19077854
J Affect Disord. 2004 Sep;81(3):231-40
15337327
Br J Psychiatry. 1995 Jan;166(1):29-34
7894872
Behav Res Ther. 1988;26(2):151-8
3365205
CMAJ. 2000 Sep 19;163(6):714-5
11022586