Social relationship correlates of major depressive disorder and depressive symptoms in Switzerland: nationally representative cross sectional study
1 Department of Psychology, Northern Arizona University, PO Box 15106, Flagstaff, AZ 86011, USA
2 Department of Psychology, Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, Bern 3012, Switzerland
3 Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern 3012, Switzerland
4 Institute for Complementary and Integrative Medicine, University of Zurich, Switzerland, Raemistrasse 100, 8006 Zurich, Switzerland
BMC Public Health 2014, 14:273 doi:10.1186/1471-2458-14-273Published: 24 March 2014
The quality and quantity of social relationships are associated with depression but there is less evidence regarding which aspects of social relationships are most predictive. We evaluated the relative magnitude and independence of the association of four social relationship domains with major depressive disorder and depressive symptoms.
We analyzed a cross-sectional telephone interview and postal survey of a probability sample of adults living in Switzerland (N = 12,286). Twelve-month major depressive disorder was assessed via structured interview over the telephone using the Composite International Diagnostic Interview (CIDI). The postal survey assessed depressive symptoms as well as variables representing emotional support, tangible support, social integration, and loneliness.
Each individual social relationship domain was associated with both outcome measures, but in multivariate models being lonely and perceiving unmet emotional support had the largest and most consistent associations across depression outcomes (incidence rate ratios ranging from 1.55-9.97 for loneliness and from 1.23-1.40 for unmet support, p’s < 0.05). All social relationship domains except marital status were independently associated with depressive symptoms whereas only loneliness and unmet support were associated with depressive disorder.
Perceived quality and frequency of social relationships are associated with clinical depression and depressive symptoms across a wide adult age spectrum. This study extends prior work linking loneliness to depression by showing that a broad range of social relationship domains are associated with psychological well-being.