Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Social network determinants of depression

A Corrigendum to this article was published on 19 November 2010

Abstract

The etiology of depression has long been thought to include social environmental factors. To quantitatively explore the novel possibility of person-to-person spread and network-level determination of depressive symptoms, analyses were performed on a densely interconnected social network of 12 067 people assessed repeatedly over 32 years as part of the Framingham Heart Study. Longitudinal statistical models were used to examine whether depressive symptoms in one person were associated with similar scores in friends, co-workers, siblings, spouses and neighbors. Depressive symptoms were assessed using CES-D scores that were available for subjects in three waves measured between 1983 and 2001. Results showed both low and high CES-D scores (and classification as being depressed) in a given period were strongly correlated with such scores in one's friends and neighbors. This association extended up to three degrees of separation (to one's friends’ friends’ friends). Female friends appear to be especially influential in the spread of depression from one person to another. The results are robust to multiple network simulation and estimation methods, suggesting that network phenomena appear relevant to the epidemiology of depression and would benefit from further study.

This is a preview of subscription content

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Figure 1
Figure 4
Figure 2
Figure 3

References

  1. Fava M, Cassano P . Major depressive disorder and dysthymic disorder. In: Stern T, Rosenbaum J, Biederman J, Fava M, Rauch S, (eds). The MGH Textbook of Comprehensive Clinical Psychiatry. Mosby-Elsevier: Philadelphia, 2008.

    Google Scholar 

  2. Greenberg PE, Leong SA, Birnbuam HG . Cost of depression: current assessment and future directions. Expert Rev Pharmacoecon Outcomes Res 2001; 1: 89–96.

    Article  Google Scholar 

  3. Engel GL . The need for a new medical model. Science 1977; 196: 129–136.

    CAS  Article  Google Scholar 

  4. Durkheim E . Suicide. Translated by John A. Spaulding and George Simpson. Edited with an Introduction by George Simpson. The Free Press: Glencoe, IL, 1951, 405pp.

    Google Scholar 

  5. Vilhjalmsson R . Life stress, social support and clinical depression: a reanalysis of the literature. Social Sci Med 1993; 37: 331–342.

    CAS  Article  Google Scholar 

  6. Kim D . Blues from the neighborhood? neighborhood characteristics and depression. Epidemiol Rev 2008; 30: 101–117.

    CAS  Article  Google Scholar 

  7. Raphael B . Unmet need for prevention. In: Andrews G, Henderson S (eds). Unmet Need in Psychiatry: Problems, Resources, Responses. Cambridge University Press: New York, 1998, pp 138–139.

    Google Scholar 

  8. Subramanian SV, Kim D, Kawachi I . Covariation in the socioeconomic determinants of self rated health and happiness: a multivariate multilevel analysis of individuals and communities in the USA. J Epidemiol Community Health 2005; 59: 664–669.

    CAS  Article  Google Scholar 

  9. Christakis NA, Fowler JH . The Spread of obesity in a large social network over 32 years’. New Engl J Med 2007; 357: 370–379.

    CAS  Article  Google Scholar 

  10. Christakis NA, Fowler JH . The collective dynamics of smoking in a large social network’. New Engl J Med 2008; 358: 2249–2258.

    CAS  Article  Google Scholar 

  11. Fowler JH, Christakis NA . Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study. Br Med J 2008; 337: a2338.

    Article  Google Scholar 

  12. Cacioppo JT, Fowler JH, Christakis NA . Alone in the crowd: the structure and spread of loneliness in a large social network. J Pers Soc Psychol, in press 2009; 97: 977–991.

    Article  Google Scholar 

  13. Cutler DM, Glaeser EL . Social interactions and smoking. NBER Working Paper Series 2007; W13477.

  14. Trogdon JG, Nonnemaker J, Pais J . Peer effects in overweight adolescents. J Health Econ 2008; 25: 1388–1399.

    Article  Google Scholar 

  15. Hatfield E, Cacioppo JT, Rapson RL . Emotional contagion. Cambridge University Press: New York, 1994.

    Google Scholar 

  16. Bearman P, Moody J . Suicide and friendships among American adolescents. Am J Public Health 2004; 94: 89–95.

    Article  Google Scholar 

  17. McPherson M, Smith-Lovin L, Cook JM . Birds of a feather: homophily in social networks. Ann Rev Sociol 2001; 27: 415–444.

    Article  Google Scholar 

  18. Carrington PJ, Scott J, Wasserman S . Models and Methods in Social Network Analysis. Cambridge University Press: Cambridge, 2005.

    Book  Google Scholar 

  19. Kannel WB, Feinleib M, McNamara PM, Garrison RJ, Castelli WP . An investigation of coronary heart disease in families: the Framingham offspring study. Am J Epidemiol 1979; 110: 281–290.

    CAS  Article  Google Scholar 

  20. Cupples LA, D’Agostino RB . Survival following initial cardiovascular events: 30 year follow-up. In: Kannel WB, Wolf PA, Garrison RJ, (eds). The Framingham Study: An epidemiological investigation of cardiovascular disease. NHLBI, NIH: Bethesda, MD, 1988.

    Google Scholar 

  21. Quan SF, Howard BV, Iber C et al. The sleep heart health study: design, rationale, and methods. Sleep 1997; 20: 1077–1085.

    CAS  PubMed  Google Scholar 

  22. Fitzpatrick GL, Modlin ML . Direct-Line Distances: International Edition. The Scarecrow Press: Metuchen, NJ, 1986.

    Google Scholar 

  23. McDowell I, Newell C . Measuring Health, a Guide to Rating Scales and Questionnaires, 2nd edn. Oxford University Press: New York, 1996.

    Google Scholar 

  24. Radloff LS . The CES-D scale: a self-report depression scale for research in the general population. J Appl Psychol Meas 1977; 1: 385–401.

    Article  Google Scholar 

  25. Weissman MM, Sholomskas D, Pottenger M, Prusoff BA, Locke BZ . Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol 1977; 706: 203–213.

    Article  Google Scholar 

  26. Boyd JH, Weissman MM, Thompson WD, Meyers JK . Screening for depression in a community sample: understanding discrepancies between depression symptom and diagnostic scales. Arch Gen Psychiatry 1982; 39: 1195–1200.

    CAS  Article  Google Scholar 

  27. Fowler JH, Christakis NA . Estimating peer effects on health in social networks. J Health Econ 2008; 27: 1400–1405.

    CAS  Article  Google Scholar 

  28. Liang KY, Zeger SL . Longitudinal data analysis using generalized linear models. Biometrika 1986; 73: 13–22.

    Article  Google Scholar 

  29. Schildcrout JS . Regression analysis of longitudinal binary data with time-dependent environmental covariates: bias and efficiency. Biostatistics 2005; 6: 633–652.

    Article  Google Scholar 

  30. King G, Tomz M, Wittenberg J . Making the most of statistical analyses: improving interpretation and presentation. Am J Pol Sci 2000; 44: 341–355.

    Article  Google Scholar 

  31. Beck N . Time-series–cross-‘tion data: what have we learned in the past few years? Ann Rev Pol Sci 2001; 4: 271–293.

    Article  Google Scholar 

  32. Kamada T, Kawai S . An algorithm for drawing general undirected graphs. Inf Process Lett 1989; 31: 7–15.

    Article  Google Scholar 

  33. Szabo G, Barabasi AL . Network effects in service usage. Available at http://lanl.arxiv.org/abs/physics/0611177 accessed 12 December 2007.

  34. O’Malley AJ, Christakis NA . The role of health traits in the longitudinal formation and dissolution of friendship ties in a large social network over 32 years. 2009. Working Paper.

  35. Fischer A (ed). Gender and Emotion; social psychological perspectives. Cambridge University Press: New York, 2000.

    Book  Google Scholar 

  36. Canary DJ, Kathryn D . Sex Differences and Similarities in Communication. Lawrence Erlbaum Associates: Mahwah, New Jersey, 1998.

    Google Scholar 

  37. Eakins B, Eakins G . Sex Differences in Human Communication 1979, Houghton Mifflin Co.: Boston, pp 147–179.

    Google Scholar 

  38. Noller P . Nonverbal Communication and Marital Interaction. Pergamon Press: Oxford, 1984.

    Google Scholar 

  39. Hall JA, Carter JD, Horgan TG . Gender differences in non-verbal communication of emotion. In: Fischer AH (ed). Gender and Emotion: Social Psychological Perspective. Cambridge University Press: Cambridge England, 2000.

    Google Scholar 

  40. Geary DC . Mxale, Female: The Evolution of Human Sex Differences. American Psychological Association Press: Washington DC, 1998.

    Book  Google Scholar 

  41. Christakis NA, Fowler JH . Connected: The Suprising Power of Our Social Networks and How They Shape Our Lives. Little Brown: New York, 2009.

    Google Scholar 

  42. Meyler D, Stimpson JP, Peek MK . Health concordance within couples: a systematic review. Soc Sci Med 2007; 64: 2297–2310.

    Article  Google Scholar 

  43. Siegel MJ, Bradley EH, Gallo WT, Kasl SV . The effect of spousal mental and physical health on husbands’ and wives’ depressive symptoms, among older adults. J Aging Health 2004; 16: 398–425.

    Article  Google Scholar 

  44. Watts DJ, Dodds PS . Networks, influence, and public opinion formation. J Consum Res 2007; 34: 441–458.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Laurie Meneades, Rebecca Joyce, Molly Collins, Marian Bellwood and Karen Mutalik for the expert assistance required to build the analytical data. We thank Maurizio Fava for helpful comments regarding the article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J N Rosenquist.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies the paper on the Molecular Psychiatry website (http://www.nature.com/mp)

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Rosenquist, J., Fowler, J. & Christakis, N. Social network determinants of depression. Mol Psychiatry 16, 273–281 (2011). https://doi.org/10.1038/mp.2010.13

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/mp.2010.13

Keywords

  • depression
  • social networks
  • sociology
  • social norms
  • mood

Further reading

Search

Quick links