Depressive symptoms in the general population a multifactorial social approach

This research aimed to provide a more systematic theoretical and empirical analysis of the relationships between social factors and depressive symptoms in the general population. A multifactorial social approach has been applied to study depressive symptoms in the general population more profoundly using several perspectives: a longitudinal perspective, a static and dynamic perspective, a contextual perspective and an explanatory perspective. Theoretical progress has been attained in this study by using a theoretical framework in which these perspectives have been incorporated and from which hypotheses have been derived on differences in people’s levels of resources that account for suffering from depressive symptoms. Testing several indicators of resources simultaneously in a large-scale research design had lead to empirical progress. The multivariate analyses were done using survey data of the national and the regional general population. With respect to a longitudinal perspective, we made the longitudinal development of depressive symptoms in society empirically feasible using data from the national population of the Netherlands. We made progress in epidemiological and sociological research since the assumption of an expected tendency for depressive symptoms to increase had, up till now, not been able to be supported. Moreover, as far as we know, this is the first study that examined the impact of over-time changes on depressive symptoms in the effects of specific positions, as well as testing period and cohort effects of national conditions of society. The static and dynamic perspective led to new hypotheses about life change events. It seemed very fruitful to look at changes in people’s positions that incorporate decreasing levels of resources and their effects on depressive symptoms. Moreover, it seemed to be even more useful to include a dynamic aspect that distinguishes between a recent and a less recent decrease in levels of resources. The results of this study clearly indicate that the distinction of recent and less recent social and economic changes, as well as inter-generational and intra-generational economic mobility, form an essential approach for understanding the effects of particular dynamic effects on depressive symptoms. The elaboration of a contextual perspective on depressive symptoms, in combination with a dynamic perspective is an enhancement on ‘places matters’ research on depressive symptoms. The theoretical specification of various neighbourhood characteristics and the empirical test using multi-level analyses offered new possibilities for testing a contextual influence on mental disorders in general and depressive symptoms specifically, more extensively. Moreover, the dynamic aspect of neighbourhoods appeared to be relevant, as we demonstrated that socio-economic improvements of neighbourhoods decrease depressive symptoms. The reducing or preventing effects on depressive symptoms as a result of redevelopments of neighbourhoods support the efforts of local policies to stimulate programs on neighbourhood improvement. From a public health perspective, these investments seem to be worthwhile, given the expected effectiveness of prevention and intervention programmes of health care policies in the local community. Finally, examining an explanatory perspective on depressive symptoms produced hypotheses on the extent to which specific subjective perceptions of distress explain the effects of resources on depressive symptoms. This application of including particular subjective perceptions of distress in addition to indicators of people’s levels of resources simultaneously, provided strong evidence that these subjective perceptions can to some extent explain suffering from depressive symptoms among specific subgroups. Subsequently, in this study, we were able to specify the conditions under which the mechanisms of subjective perceptions of distress are intensified. This explanatory perspective appears to be a theoretical constructive factor in sociological research on depressive symptoms. Moreover, we assessed empirically the effects of particular perceptions of distress on depressive symptoms, which in many studies remained an implicit theoretical factor. Studying the role of intervening factors of subjective perspectives is an important factor that leads to theoretical and empirical progress in sociological research on depressive symptoms. The results show the importance of a simultaneous test of different social factors that induce depressive symptoms in the general population.