The relationship between social support and major depression

the relationship between social support and major depression

This chapter reviews research, theory, and methods regarding the link between low social support and clinical depression. The chapter is organized into three. Jan 2, Numerous studies report an association between social support and . Barth, J. Social relationship correlates of major depressive disorder and. Sex Differences in the Relationship Between. Social Support and Risk for Major Depression: A Longitudinal Study of Opposite-Sex Twin Pairs. Kenneth S.

Next, we performed a backward stepwise logistic regression by including all variables simultaneously and then removing the non-significant ones, testing two-way interactions of gender and all other covariates, as gender can influence differently the other predictors evaluated. The final model was obtained with a backward elimination of non-significant variables using the Wald x2 test.

In all analyses, the reference category was the control group which was defined as people aged 60 or more, with no lifetime depressive episode or dysthymia, and no lifetime subthreshold depression. All evaluations of significance are based on two-sided tests using the 0. However, eight of them had a lifetime diagnosis of depressive episode or dysthymia according to ICD, but these symptomatology was not presented in the age period considered.

As our aim was to verify the association of late life depressive symptoms with current social support and previous two years life events, these subjects were excluded from the analysis. Therefore, in this report, all analyses were performed in the subsample of subjects aged 60 years or more mean age In this subsample, 37 subjects presented a depressive episode with onset or recency after 60 years, the ''late depression'' subgroup These two subgroups were collapsed into a broader ''old age symptomatic depression'' group, comprised by The gender distribution of the control group was Table 1 shows frequencies of each predictor considered herein in the two groups.

In the univariate analysis, female gender was a determinant for ''old age symptomatic depression''. Respondents with ''old age symptomatic depression'' were five times more likely to present a comorbid anxiety disorder, and were also more likely to live alone, when compared to the control group.

Life events and bereavement were reported by a higher proportion of cases, although the comparison across groups was not significant. All other predictors had equal distributions across the case and control groups, with odds ratios close to 1. Respondents with severe neurocognitive impairment were not able to participate.

the relationship between social support and major depression

This presumably precluded our ability to capture the well clinically documented old age psychopathology. This is reflected in the small number of men with the outcome examined herein. Some of these caveats may have biased our results to an underestimation of the prevalence of depression, restricted the possibility to better detect differences in the subtypes ''late depression'' and ''late subthreshold depression'', and may probably make the strengths of associations weaker.

In addition, because the survey site is consisted of two boroughs of Sao Paulo with a high socioeconomic level, it is difficult to generalize the results to other socioeconomic strata and, thus, these findings should not be extended to other communities. Further limitations of the study are the cross-sectional design, thus it is not possible to detect the direction of the association.

Social support

Notwithstanding these limitations, we found that approximately one in each five elderly Bearing in mind that this estimate does not represent lifetime estimates, as cases were restricted to those subjects who presented symptomatic depression with onset or recency after 60 years of age, and that comparisons with previous studies in Brazil are hampered by different assessment, time frame, studies design and objectives, our findings are consistent with previous studies in Brazil, in showing a high prevalence of depressive symptomatology in this age group.

There is no consensus concerning the influence of female gender in depression in old age. Depression in late life tends to co-occur with other psychiatric disorders, though this co-occurrence seems to be less frequent than earlier in life. In our survey, cognitive impairment was not associated with ''old age symptomatic depression''. The exclusion of severe cognitive impairment subjects, low sample size, and validity of measurements might have made this association weaker in our survey.

This association is common in clinical practice, and probably what is captured in surveys in clinical samples is the end of a continuum that could start with depressive symptoms in later life. Older adults who live alone tend to report less social support and more loneliness, and to experience accelerated cognitive decline. In our survey, life events and social support operate differentially across genders. Perceived lack of social support was significantly associated with ''old age symptomatic depression'' in men, while life events were associated with ''old age symptomatic depression'' in women.

In recent decades, the elders had to deal with two key points in their lives: Although we could not observe this in our study, the literature is well-documented with respect to the role that a confidante plays in the maintenance of psychological well-being and mental health. Since men earn, on average, substantially more than women,34 women usually obtain more financial advantages from marriage. Perceived lack of social support was an important predictor of ''old age symptomatic depression'' only for men.

Social Support and Physical Health

It seems that the death of the wife tends to lead to a loss of social support over time, and this can be an explanation for the difference in depression rates between men and women after widowhood; there is a stronger association for men, especially among those widowed for a longer period of time. Because men are less likely to have a close confiding relationship with another person than women,33 the death of their wife can place a man in a situation in which he must cope with the loss of, perhaps, his only confidante.

Furthermore, friends in a similar age group tend to be married, or have entered into a new marriage, and this can increase the sense of loneliness and the perceived lack of social support. In conclusion, our findings contribute to the literature by studying a subtype of depression occurring in later life.

Moreover, the gender differences found here in relation to life events and social support can contribute to a better understanding of the functioning of elderly people facing difficult, but common, situations in their lives.

This is expected to help health professionals provide guidance to families to build a network of support capable of reducing the risk of depression in their elderly family members. Mental disorders in Latin America and the Caribbean: Rev Panam Salud Publica. Depression morbidity in later life: Am J Geriatr Psychiatry.

Prevalence of International Classification of Diseases, 10th Revision common mental disorders in the elderly in a Brazilian community: The Bambui Health Ageing Study. Depressive morbidity and gender in community-dwelling Brazilian elderly: Demographic and health conditions of ageing in Latin America and the Caribbean. Survey data for the study of aging in Latin America and the Caribbean: Origins of depression in later life.

Prevalence and predictors of depression in populations of elderly: Social support deficits, loneliness and life events as risk factors for depression in old age. Negative life events and depression in elderly persons: Depressive symptoms and aging: Social relationships and mortality risk: Adverse life events among community-dwelling persons aged years: Soc Psychiatry Psychiatr Epidemiol.

Association between social support and depression status in the elderly: The influence of adversity and perceived social support on the outcome of major depressive disorder in subjects with different levels of depressive symptoms. Subsyndromal depression in the elderly: Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. The detection of depression in medical setting: Census of Population and Housing: A practical method for grading the cognitive state of patients for the clinician.

The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. Bull World Health Organ. Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy. According to Hwang, the support is similar to face-to-face social support, but also offers the unique aspects of convenience, anonymity, and non-judgmental interactions.

Research conducted by Winzelberg et al.

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Social support through social media is available to everyone with internet access and allows users to create relationships and receive encouragement for whatever issue they may be facing. Coulson claims online support groups provide a unique opportunity for health professionals to learn about the experiences and views of individuals. Seeking informational social support allows users to access suggestions, advice, and information regarding health concerns or recovery.

Many need social support, and with its emergence on social media access can be obtained from a wider range of people in need. Wong and Ma have done research that shows online social support affects users' online subjective well-being.

People with low social support report more sub-clinical symptoms of depression and anxiety than do people with high social support.

Psychiatry: life events and social support in late life depression

These include posttraumatic stress disorder[49] panic disorder[50] social phobia[51] major depressive disorder, [52] dysthymic disorder[53] and eating disorders.

Many people with eating disorders have a low perceived susceptibility, which can be explained as a sense of denial about their illness. Their perceived severity of the illness is affected by those to whom they compare themselves to, often resulting in people believing their illness is not severe enough to seek support.

Due to poor past experiences or educated speculation, the perception of benefits for seeking social support is relatively low. The number of perceived barriers towards seeking social support often prevents people with eating disorders from getting the support they need to better cope with their illness. Such barriers include fear of social stigma, financial resources, and availability and quality of support. Self-efficacy may also explain why people with eating disorders do not seek social support, because they may not know how to properly express their need for help.

This research has helped to create a better understanding of why individuals with eating disorders do not seek social support, and may lead to increased efforts to make such support more available.

Eating disorders are classified as mental illnesses but can also have physical health repercussions. Creating a strong social support system for those affected by eating disorders may help such individuals to have a higher quality of both mental and physical health. Interest in the implications of social support were triggered by a series of articles published in the mids, each reviewing literature examining the association between psychiatric disorders and factors such as change in marital status, geographic mobility, and social disintegration.

This observed relationship sparked numerous studies concerning the effects of social support on mental health.

One particular study documented the effects of social support as a coping strategy on psychological distress in response to stressful work and life events among police officers. Talking things over among coworkers was the most frequent form of coping utilized while on duty, whereas most police officers kept issues to themselves while off duty. The study found that the social support between co-workers significantly buffered the relationship between work-related events and distress.

One study by D'Ercole demonstrated that the effects of social support vary in both form and function and will have drastically different effects depending upon the individual. The study found that supportive relationships with friends and co-workers, rather than task-related support from family, was positively related to the mother's psychological well-being. D'Ercole hypothesizes that friends of a single parent offer a chance to socialize, match experiences, and be part of a network of peers.

These types of exchanges may be more spontaneous and less obligatory than those between relatives. Additionally, co-workers can provide a community away from domestic life, relief from family demands, a source of recognition, and feelings of competence. D'Ercole also found an interesting statistical interaction whereby social support from co-workers decreased the experience of stress only in lower income individuals.

The author hypothesizes that single women who earn more money are more likely to hold more demanding jobs which require more formal and less dependent relationships. Additionally, those women who earn higher incomes are more likely to be in positions of power, where relationships are more competitive than supportive. In a study by Haden et al. These results suggest that high levels of social support alleviate the strong positive association between level of injury and severity of PTSD, and thus serves as a powerful protective factor.

In fact, a meta-analysis by Brewin et al. In some cases, support decreases with increases in trauma severity. Reports between and showed college stresses were increasing in severity. A study by Chao found a significant two-way correlation between perceived stress and social support, as well as a significant three-way correlation between perceived stress, social support, and dysfunctional coping.

The results indicated that high levels of dysfunctional coping deteriorated the association between stress and well-being at both high and low levels of social support, suggesting that dysfunctional coping can deteriorate the positive buffering action of social support on well-being. People with low social support are at a much higher risk of death from a variety of diseases e.

Conversely, higher rates of social support have been associated with numerous positive outcomes, including faster recovery from coronary artery surgery, [82] less susceptibility to herpes attacks, [83] [84] a lowered likelihood to show age-related cognitive decline, [85] and better diabetes control.

the relationship between social support and major depression

Community services known by the nomenclature community support, and workers by a similar title, Direct Support Professional, have a base in social and community support "ideology". Social support theories are often found in "real life" in cultural, music and arts communities, and as might be expected within religious communities.

Social support is integral in theories of aging, and the "social care systems" have often been challenged e. Although there are many benefits to social support, it is not always beneficial. It has been proposed that in order for social support to be beneficial, the social support desired by the individual has to match the support given to him or her; this is known as the matching hypothesis.

For example, received support has not been linked consistently to either physical or mental health; [17] [23] perhaps surprisingly, received support has sometimes been linked to worse mental health.