Cited by 482Mental Health Treatment and AccessTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The DOI matches its Crossref record; 485 of the 487 references it cites were found in a registry or an index; 1 of the 126 sources its claims cite were checked for support.

Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature

Open access
Remes, Olivia, Mendes, João Francisco, Templeton, Peter·2021·Brain Sciences

Abstract

Depression is one of the leading causes of disability, and, if left unmanaged, it can increase the risk for suicide. The evidence base on the determinants of depression is fragmented, which makes the interpretation of the results across studies difficult. The objective of this study is to conduct a thorough synthesis of the literature assessing the biological, psychological, and social determinants of depression in order to piece together the puzzle of the key factors that are related to this condition. Titles and abstracts published between 2017 and 2020 were identified in PubMed, as well as Medline, Scopus, and PsycInfo. Key words relating to biological, social, and psychological determinants as well as depression were applied to the databases, and the screening and data charting of the documents took place. We included 470 documents in this literature review. The findings showed that there are a plethora of risk and protective factors (relating to biological, psychological, and social determinants) that are related to depression; these determinants are interlinked and influence depression outcomes through a web of causation. In this paper, we describe and present the vast, fragmented, and complex literature related to this topic. This review may be used to guide practice, public health efforts, policy, and research related to mental health and, specifically, depression.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review synthesized recent literature on biological, psychological, and social determinants of depression, including 470 documents published between 2017 and 2020. It concludes that risk and protective factors are interlinked across individual and wider ecological levels and influence depression through a complex web of causation.

Key findings

  • From 6335 identified documents, 470 papers were included. Determinants spanned biological factors (genetics, microbiome, inflammation, HPA-axis dysfunction, kynurenine pathway, cognition), psychological factors (rumination, neuroticism, negative self-concept, low self-esteem, maladaptive coping), and social factors (socioeconomic status, social support, adverse childhood experiences, gender, diet, and others).
  • Women were found to be twice as likely to have depression as men, and depression was estimated to have a prevalence of 5% among adults.
  • Biological findings included links between depression and pro-inflammatory cytokines such as TNF-alpha, BDNF (including the rs6265 allele A with major depressive disorder), HPA-axis dysregulation, and the kynurenine pathway.
  • Social and psychological findings included associations between low education and low income and depression, high education and income as protective, adverse childhood experiences increasing risk, and rumination acting as both a risk factor and mediator.

Methods

  • Literature review of biological, psychological, and social determinants of depression, focusing on documents published 2017–2020. Searches were conducted in PubMed, Medline, Scopus, and PsycInfo; inclusion covered primary studies, reviews, systematic reviews, meta-analyses, reports, and commentaries on human and/or rodent research, while treatment-focused studies and studies assessing depression as a comorbidity or secondary disorder were excluded.
  • Titles and abstracts were screened, then full texts were assessed. Screening was conducted by O.R., with a subsample screened by J.M.; discrepancies were resolved through communication. A data charting form was piloted on 20 studies, and narrative analysis was used to identify key themes.
  • The review attempted to follow PRISMA guidelines in several aspects.

Limitations

  • Stated in the paper: the review may have missed potentially important studies, though this is described as unavoidable for literature reviews; the aim was not to identify every study on depression risk and protective factors but to gain insight into the breadth of literature and key themes.
  • Evident from the text: heterogeneity in study design and measurement, and lack of standardization for measuring depression and its determinants, make comparison across studies difficult; findings in some areas, such as genetics, remain mixed.
  • Evident from the text: the review is a narrative synthesis and does not describe a formal quality appraisal or meta-analytic pooling of results.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3390/brainsci11121633

Cites

485 of 485 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

79 Not checked yet · 28 No basis given · 15 Own interpretation · 7 Own method · 3 Own result · 1 Supported

Verify all 125 references — free account

Show all 73 claims

  • Probably not a substantial claim. 35
  • It may state two separate claims as one. 39
60 of 60
  • The paper relies on this without support.

    Previous syntheses on depression are limited in scope and focus exclusively on social or biological factors, population sub-groups, or examine depression as a comorbidity rather than an independent disorder.

    “The previous syntheses on depression are limited in scope and focus exclusively on social or biological factors, population sub-groups, or examine depression as a comorbidity (rather than an independent disorder).”
  • The paper relies on this without support.

    Research on the determinants and causal pathways of depression is fragmented and heterogeneous, and this has not helped to stimulate progress in prevention and intervention.

    “The research on the determinants and causal pathways of depression is fragmentated and heterogeneous, and this has not helped to stimulate progress when it comes to the prevention and intervention of this condition—specifically unravelling the complexity of the determinants related to this condition and thus refining the prevention and intervention methods.”
  • The paper relies on this without support.

    Early life is a critical period during the lifespan at which cognitive processes develop.

    “Early life is a critical period during the lifespan at which cognitive processes develop.”
  • The paper relies on this without support.

    Older people are at a heightened risk of losing their social networks.

    “Older people are at a heightened risk of losing their social networks”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

Show all 487 references

Research works printed but not linked: 5

  1. Lima, 2019, Depressive Symptoms among the Elderly in Sao Paulo city, Brazil: Prevalence and Associated Factors (SABE Study), Rev. Bras. De Epidemiol., 21, e180014
  2. Wang, 2020, Advance in relationship between receptor gene abnormality and depression, Yaoxue Xuebao, 55, 384
  3. Salgado, 2018, A new theory of depression based on the serotonin/kynurenine relationship and the hypothalamicpituitary- adrenal axis, Biomedica, 38, 437
  4. Ortiz, 2017, Determinants associated with chronic and incident depression in Mexican older adults, Gac. Med. De Mex., 153, S102
  5. Pramod, 2019, Lifestyle and substance use-an important cause for treatment-resistant depression and major depressive disorders, Drug Invent. Today, 11, 284

Cited by

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Items 101–200 of 482

Metadata

Authors
Remes, O., Mendes, J. F., & Templeton, P.
Affiliations
  • University of Cambridge (GB)
  • Universidade Nova de Lisboa (PT)
Corresponding author
Remes, Olivia
Venue
Brain Sciences
Publisher
MDPI AG
Published
2021-12-10
Volume
11
Issue
12
Pages
1633
ISSN
2076-3425 (ISSN-L)
OpenAlex
W4200206491
Cited by
482
References
487
Citations by year
2026: 127 · 2025: 173 · 2024: 117 · 2023: 53 · 2022: 12
FWCI
7.15
Type
journal article
Language
en
Open access
Locations
  • Brain Sciences (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Apollo
  • Apollo (cc-by)
Funders
  • The William Templeton Foundation for Young People's Mental Health (NA)
  • Cambridge Philosophical Society (NA)
  • Aviva Foundation (NA)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
depression, biological determinants, psychological factors, social determinants, risk factors, protective factors, depression outcomes, suicide risk, mental health

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