Jul 2026· International Journal of Social Psychiatry· pp.
207640261470091
· 0 citations· 38 references
Medicine
TL;DR
The findings support social determinants framework for understanding depression, highlighting the contribution of social adversity, environmental stressors, and relational factors to the development and severity of depressive symptoms.
Abstract
Background
Depression is a leading global health concern and is projected to become one of the major contributors to the global burden of disease in the coming decades. Increasing evidence highlights the role of social determinants-including socioeconomic conditions, social relationships, life stressors, discrimination, and environmental influences-in shaping the risk and clinical expression of depressive disorders. This study aimed to investigate social determinants associated with the presence and severity of depressive symptoms in Italian general population.
Methods
A cross-sectional survey was conducted among 1,036 adults from the Italian general population, recruited through personal networks and online platforms using snowball sampling. Participants completed a structured questionnaire assessing sociodemographic characteristics, social support, stressful life events, quality of life, minority stress experiences, social media use, environmental and societal concerns, substance use, and mental health symptoms. Comparative analyses were performed between individuals reporting a clinician-diagnosed depressive disorder (n = 143; 13.8%) and those without a diagnosis (n = 893).
Results
Participants with a depressive disorder reported significantly higher exposure to multiple adverse social determinants. They were more likely to experience stressful life events, reduced perceived social support, poorer quality of life, minority stress, and negative psychosocial effects related to social media use. Concerns regarding broader socio-environmental issues, including political instability and climate change, were also more prevalent in the diagnosed group. These social vulnerabilities were accompanied by greater severity of depressive symptoms, anxiety-related manifestations, impulse-control difficulties, aggressive behaviors, and the use of substances as a coping strategy (all p ⩽ .003).
Conclusions
The findings support social determinants framework for understanding depression, highlighting the contribution of social adversity, environmental stressors, and relational factors to the development and severity of depressive symptoms. Population-based surveys can help identify vulnerable groups and inform preventive strategies and public health interventions aimed at addressing the social conditions that contribute to depression.
Depression and anxiety contribute substantially to the mental health burden in low- and middle-income countries, yet clinic-based evidence from Pakistan remains limited. This study examined the distribution of depressive and anxiety symptom severity and their sociodemographic correlates in outpatient mental health clinics in Pakistan. This cross-sectional study included 267 participants recruited through consecutive sampling from four urban outpatient mental health clinics in Pakistan. Depression and anxiety were assessed using Hamilton Depression Rating Scale-17 and Generalized Anxiety Disorder Scale-7, respectively. Symptom severity was categorized as low, moderate, and high based on cut-offs (HDRS-17: 0–13, 14–26, ≥ 27; GAD-7: 0–9, 10–14, ≥ 15). Sociodemographic correlates included gender, age, marital status, educational attainment, employment status, and socioeconomic status. Multinomial logistic regression was used to estimate adjusted associations. Moderate-to-high symptom severity was common for both depression and anxiety. For depression, 64.8% of participants had high depressive symptom severity and 22.3% had moderate symptom severity. For anxiety, 32.6% had high anxiety symptom severity and 30.3% had moderate symptom severity. In adjusted analyses, unemployment was significantly associated with higher depression severity (OR = 2.55, 95% CI: 1.23–5.29). Low socioeconomic status was associated with moderate anxiety severity (OR = 6.08, 95% CI: 1.97–8.75), while middle socioeconomic status was associated with higher anxiety severity (OR = 6.11, 95% CI: 2.79–13.23). Gender, age, marital status, and education showed no consistent adjusted associations. This study extends clinic-based mental health evidence from Pakistan by showing that depressive and anxiety symptom severity is strongly patterned by socioeconomic disadvantage. The findings shift attention from individual symptom burden alone to the broader social conditions shaping clinical mental health presentations.
Anwar Khan, Amalia Bt Madihie· Discover Public Health· 0 citations
Introduction: Anxiety and depression are the most prevalent mental health disorders worldwide, placing an increasing burden on public health systems. However, certain transdiagnostic factors may modulate vulnerability to these disorders: personality traits, emotional regulation, and social support. Objective: To examined these factors, classifying them as either risk or protective through correlation analyses and qualitative comparative analyses in a clinical sample. Methods: After applying inclusion and exclusion criteria, the final sample consisted of 61 participants (73.8% female, 24.6% male, 1.6% other genders) aged between 20 and 66 years (M = 43.79; SD = 12.75). Results: Neuroticism was associated with higher levels of anxiety and depression, whereas extraversion predicted better mental health. Additionally, emotion dysregulation correlated positively with both psychopathologies. Finally, perceived social support emerged as a sufficient condition for lower anxiety levels; conversely, its absence was linked to higher levels of both anxiety and depression. Conclusions: These findings highlight the importance of further investigating risk and protective factors related to highly prevalent mental health problems like anxiety and depression. Better understanding these factors can help improve assessment, diagnosis, and treatment within clinical practice.
Selene Valero-Moreno, Olga Ribera-Asensi, Saray Giménez-Benavent et al.· Universitas Médica· 0 citations
Background: Depression is a major global public health concern, particularly in low- and middle-income countries where access to mental health services is limited. In Myanmar, the burden of mental health disorders is increasing especially in conflict-affected regions such as Eastern Shan State. While prevalence studies exist, limited research has explored the determinants of depression severity using robust statistical approaches.
Objective: This study aimed to examine the factors associated with increasing severity of depressive symptoms among adults in Eastern Shan State, Myanmar using a generalized ordered logistic regression model.
Methods: An analytical cross-sectional study was conducted among 448 adults aged 18–59 years in Eastern Shan State. A structured interviewer-administered questionnaire was used to collect data on demographic, behavioural and psychosocial factors. Validated tools including CESD-10, GAD-7, SPRINT and MPSS were used. An ordered logistic regression model (ologit in STATA) was applied to identify factors associated with increasing severity of depressive symptoms, allowing relaxation of the proportional odds assumption where necessary.
Results: Based on the CES-D 10 scale, 53.6% (95%CI:48.92-58.16) of participants had mild or no depressive symptoms, 35.9% (95%CI:31.61-40.50) had moderate symptoms and 10.5% (95%CI:7.97-13.70) had severe depressive symptoms. Multivariable ordinal logistic regression identified individuals who were unemployed (AOR = 1.78, 95%CI:1.17-2.71), had inadequate financial status (AOR = 2.44, 95%CI:1.65-3.62), reported poor self-rated health (AOR = 3.01, 95%CI:1.89-4.82), trauma exposure (AOR = 1.88, 95%CI:1.26-2.82), forced displacement (AOR = 1.94, 95%CI:1.07-3.54), spending more than two hours daily on socio-political news (AOR = 2.34, 95%CI:1.57-3.50) and poor sleep efficiency (AOR = 3.07, 95%CI:1.49-6.35) were significantly associated with greater severity of depressive symptoms.
Conclusion: The study highlights key socio-behavioural and psychological determinants of depression severity in a conflict-affected population. Integrated mental health services targeting these risk factors are urgently needed to address the burden of depression in Eastern Myanmar and similar fragile contexts.
Thein Myint Twin, K. M. Htike, R. K. Mahato· International Journal of Pub...· 0 citations
Mental disorders represent a major public health burden worldwide, disproportionately affecting women in low- and middle-income countries. The perinatal period is a time of increased biological, psychological, and social vulnerability, heightening the risk of depressive, anxiety, and stress symptoms. Despite the high relevance, data on maternal mental health in Mozambique remain scarce.
A cross-sectional study was conducted in two health centers in Maputo. Pregnant women aged ≥ 18 years were systematically recruited. Psychological symptoms were assessed using the DASS-21. Prevalence ratios for depressive, anxiety, and stress symptoms were estimated using Poisson regression with robust variance.
Clinically significant symptoms (moderate to extremely severe) were observed in 38.9% of participants for depression, 57.6% for anxiety, and 14.4% for stress. Additional factors significantly associated with symptoms included household composition, marital status, family history of mental illness, occupational status, religion, and family planning practices.
The findings highlight substantial psychosocial and structural vulnerabilities among pregnant women in Maputo. Systematic screening integrated into prenatal care, policies addressing economic and occupational insecurity, and further research exploring protective factors and culturally relevant interventions are warranted.
Elisa Paulo Joaquim Barros, A. Fumo, M. Moçambique· BMC Psychology· 0 citations
Introduction Mental health problems in young adults with hypertension are often underrecognized, despite their potential impact on quality of life and long-term outcomes. Evidence in younger populations remains limited, particularly in longitudinal and multicenter settings. Objective To examine the relationship between hypertension duration, mental health symptoms, and quality of life among young adults, as well as to explore psychosocial stressors identified through qualitative inquiry. Methods This multicenter longitudinal study recruited patients aged 18–45 years with hypertension from outpatient clinics across several Indonesian cities. Participants were assessed at baseline using the Depression Anxiety Stress Scale-21 (DASS-21) and the WHO Quality of Life-BREF (WHOQOL-BREF). Hypertension duration was recorded as a continuous variable. A subset of participants underwent semi-structured interviews to explore psychosocial stressors. Quantitative data were analyzed using correlation analysis, while qualitative data were analyzed thematically. Results A total of 791 participants were included in the study, with a mean age of 33 ± 10.14 years, and women slightly outnumbered men. This study found that a longer duration of hypertension was associated with worse overall quality of life (r = -0.45) and lower psychological well-being (r = -0.40). Notable correlations also emerged between hypertension duration and higher levels of anxiety (r = -0.42), depression (r = -0.38), and stress (r = -0.30), while socioeconomic and psychosocial stressors emerged as major contributing factors. Discussion This multicenter longitudinal study suggests a direct link between early-adulthood hypertension and subsequent psychological distress, particularly anxiety and depressive symptoms, as well as lower quality of life with aging. Recent findings underscore that hypertension in young individuals extends beyond cardiovascular risk and may also impose a substantial mental health burden. Evidence identifying socioeconomic and psychosocial stressors as key predisposing factors further strengthens the rationale for incorporating routine mental health screening and psychosocial interventions into standard hypertension management protocols, thereby enhancing patients’ quality of life and potentially improving long-term clinical outcomes. Conclusion In this multicenter longitudinal cohort, a longer duration of hypertension was associated with greater psychological distress and poorer quality of life among young adults. These findings support the integration of routine mental health screening into hypertension care.
E. Effendy, M. M. Amin, V. Camellia et al.· Clinical Practice and Epidem...· 0 citations
Background: Major depressive disorder (MDD) is a widespread health issue linked to high mortality rates, functional impairment, disability, increased healthcare expenses, reduced quality of life, and psychosocial dysfunction. Dysfunction in social participation, productivity, and sense of subjective well-being persists even after reduction in depressive symptoms. Achieving symptomatic remission is not enough in the treatment of depression, but also understanding, assessing functional impairment, and Quality of Life together with symptom severity should be a holistic approach for the treatment of depression.
Methods: A cross-sectional comparative study design was used. 60 individuals with depression samples were collected based on the purposive sampling method from a tertiary care hospital. Another 60 samples were collected from the general population for the normal control group on the basis of inclusion and exclusion criteria.
Results: There were significant differences found in all four domains of QoL between the experimental and control groups, where the normal control group outperformed in all four domains of QoL with higher mean scores than the experimental group. The global score of the experimental group in WHODAS varies significantly (p=0.00) from the control group. The experimental group has higher dysfunction (83.28±10.29) in comparison to the control group (59.50±9.54).
Conclusions: Functional impairment and QoL functioning are significantly affected in persons with depression. Shifting focus from only depression symptoms severity to consideration of functional impairment and QoL functioning would be a holistic approach for depression assessment and management.
P. K. Sethi, Jashobanta Mahapatra· International Journal of Com...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
