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. 2013 Apr 30;8(4):e62396.
doi: 10.1371/journal.pone.0062396. Print 2013.

Social Relationships and Depression: Ten-Year Follow-Up From a Nationally Representative Study

Free PMC article

Social Relationships and Depression: Ten-Year Follow-Up From a Nationally Representative Study

Alan R Teo et al. PLoS One. .
Free PMC article


Background: Social network characteristics have long been associated with mental health, but their longitudinal impact on depression is less known. We determined whether quality of social relationships and social isolation predicts the development of depression.

Methods: The sample consisted of a cohort of 4,642 American adults age 25-75 who completed surveys at baseline in 1995-1996 and at ten-year follow-up. Quality of relationships was assessed with non-overlapping scales of social support and social strain and a summary measure of relationship quality. Social isolation was measured by presence of a partner and reported frequency of social contact. The primary outcome was past year major depressive episode at ten-year follow-up. Multivariable logistic regression was conducted, adjusting for the presence of potential confounders.

Results: Risk of depression was significantly greater among those with baseline social strain (OR, 1.99; 95% CI, 1.47-2.70), lack of social support (OR, 1.79; 95% CI, 1.37-2.35), and poor overall relationship quality (OR 2.60; 95% CI, 1.84-3.69). Those with the lowest overall quality of social relationships had more than double the risk of depression (14.0%; 95% CI, 12.0-16.0; p<.001) than those with the highest quality (6.7%; 95% CI, 5.3-8.1; p<.001). Poor quality of relationship with spouse/partner and family each independently increased risk of depression. Social isolation did not predict future depression, nor did it moderate the effect of relationship quality.

Conclusions: Quality of social relationships is a major risk factor for major depression. Depression interventions should consider targeting individuals with low quality of social relationships.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.


Figure 1
Figure 1. Predicted probability of depression.
Impairment in quality of social relationships was rated on a four-point scale, with a higher score indicating more impairment in overall quality in relationships with spouse/partner, family, and friends. Data are weighted to adjust results to more closely match characteristics of the general U.S. population.

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    1. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, et al. (2003) The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 289: 3095–3105. - PubMed
    1. Stewart JC, Zielke DJ, Hawkins MA, Williams DR, Carnethon MR, et al. .. (2012) Depressive Symptom Clusters and 5-Year Incidence of Coronary Artery Calcification: The CARDIA Study. Circulation. - PMC - PubMed
    1. Kouwenhoven SE, Kirkevold M, Engedal K, Kim HS (2011) Depression in acute stroke: prevalence, dominant symptoms and associated factors. A systematic literature review. Disabil Rehabil 33: 539–556. - PubMed
    1. Jim HS, Small BJ, Minton S, Andrykowski M, Jacobsen PB (2012) History of major depressive disorder prospectively predicts worse quality of life in women with breast cancer. Ann Behav Med 43: 402–408. - PMC - PubMed
    1. World Health Organization (2008) The Global Burden of Disease: 2004 Update. Geneva.

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