Depressive symptoms, social support, and health-related quality of life: A community-based study in Shanghai, China

Wang, Jie; Zou, Runyu; Wu, Ning; Fu, Hua; He, Yanling; Crawford, Paul; Kane, Eddie; Dai, Junming

Abstract

Background
Depressive symptoms erode both physical and mental aspects of health-related quality of life (HRQoL). Social support (SS) may improve HRQoL through its direct effects or buffering effects. The association among depressive symptoms, SS, and HRQoL has been studied in specific groups, but research in the general adult population remains limited. This study examined the association among depressive symptoms, SS, and HRQoL, including exploring whether SS (including its three dimensions: subjective SS, objective SS and support utilization) mediated or moderated the relationship between depressive symptoms and HRQoL among community-based adults.

Methods
We conducted a cross-sectional survey in six communities in Shanghai, China, and 1642 adult participants with complete information on depressive symptoms and/or SS, and HRQoL were included. Linear regression analysis was used to investigate the association among depressive symptoms, SS, and HRQoL. In addition, we explored the mediating and moderating role of SS in the relationship between depressive symptoms and HRQoL.

Results
More depressive symptoms were associated with lower physical HRQoL (B = −0.64, p < .001) and lower mental HRQoL (B = −0.83, p < .001). SS (B = 0.07, p = .02), specifically subjective SS (B = 0.09, p = .03), was positively related to mental HRQoL. After adjusting for covariates, we found no evidence for a mediating role of SS in the relationship between depressive symptoms and HRQoL, while SS (subjective SS and objective SS) moderated the association between depressive symptoms and mental HRQoL.

Limitations
Due to the low voluntary participation rate of employees, participants represented approximately 50% of the individuals approached, thus limiting the generalizability of our findings. Data collected through self-report scales could lead to information bias.

Conclusions
SS does not appear to underlie the relationship between depressive symptoms and HRQoL. However, interventions to increase SS (in particular, subjective SS and objective SS) should be studied to determine whether they may be beneficial in alleviating the adverse impact of depressive symptoms on mental HRQoL.

Citation

Wang, J., Zou, R., Wu, N., Fu, H., He, Y., Crawford, P., …Dai, J. (2022). Depressive symptoms, social support, and health-related quality of life: A community-based study in Shanghai, China. Comprehensive Psychiatry, 113, Article 152292. https://doi.org/10.1016/j.comppsych.2021.152292

• Journal Article Type: Article
• Acceptance Date: Dec 18, 2021
• Online Publication Date: Dec 20, 2021
• Publication Date: 2022-02
• Deposit Date: Jan 4, 2022
• Publicly Available Date: Jan 5, 2022
• Journal: Comprehensive Psychiatry
• Print ISSN: 0010-440X
• Electronic ISSN: 1532-8384
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 113
• Article Number: 152292
• DOI: https://doi.org/10.1016/j.comppsych.2021.152292
• Keywords: Psychiatry and Mental health; Clinical Psychology
• Public URL: https://nottingham-repository.worktribe.com/output/7162745
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0010440X21000705
• Additional Information: This article is maintained by: Elsevier; Article Title: Depressive symptoms, social support, and health-related quality of life: A community-based study in Shanghai, China; Journal Title: Comprehensive Psychiatry; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.comppsych.2021.152292; Content Type: article; Copyright: © 2021 The Authors. Published by Elsevier Inc.