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

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

doi:10.1016/j.comppsych.2021.152292

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

Compr Psychiatry. 2022 Feb:113:152292. doi: 10.1016/j.comppsych.2021.152292. Epub 2021 Dec 20.

Authors

Jie Wang¹, Runyu Zou², Ning Wu¹, Hua Fu¹, Yanling He³, Paul Crawford⁴, Eddie Kane⁴, Junming Dai⁵

Affiliations

¹ Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, China.
² Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, China; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
³ Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁴ Institute of Mental Health, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom.
⁵ Department of Preventive Medicine and Health Education, School of Public Health, Fudan Health Communication Institute, Fudan University, Shanghai, China. Electronic address: jmdai@fudan.edu.cn.

PMID: 34959003
DOI: 10.1016/j.comppsych.2021.152292

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.

Keywords: Depression; Health-related quality of life; Mediation; Moderation; Social support.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
China / epidemiology
Cross-Sectional Studies
Depression* / diagnosis
Depression* / epidemiology
Humans
Quality of Life*
Social Support