## 2 Mental Health: Limitations, Gaps, and Research Avenues
### Dimensions of Multidimensional Depression  
The multidimensionality of depression diagnosis is addressed in this research through a framework composed of eleven dimensions: chronic diseases, economics, education, gender, social habits, age, place of residence, professional, psychological, physical-cognitive health, and mental health. Table 1 presents a summary of these dimensions. \begin{table}
\begin{tabular}{c c c c} \hline
**Nature** & **Dimension** & **Description** & **References** \\ \hline \multirow{4}{*}{Socioeconomic} & \multirow{4}{*}{Economic} & Income is associated with greater & \\  & & well-being and easier access to private & [64; 65] \\  & & health services. & \\ \cline{1-1}  & & Use of alcohol and tobacco, practice of & \\ \cline{1-1}  & & & sports, or having pets. & [66; 67; 68] \\ \cline{1-1}  & & Place of residence & Reflects the person’s socioeconomic and & \\ \cline{1-1} \cline{2-5}  & & & cultural factors. & [69; 70] \\ \hline \multirow{4}{*}{Demographic} & \multirow{4}{*}{Educational} & Education level is closely related to the & \\  & & income dimension and its impacts on & [71; 72] \\ \cline{1-1}  & & depression. & \\ \cline{1-1}  & & The female gender has been more related & \\ \cline{1-1}  & & to depression than the male gender. & \\ \cline{1-1}  & & Age & Age is associated with neurobiological & \\ \cline{1-1}  & & & changes, the loss of loved ones, and & [75] \\ \cline{1-1}  & & social isolation. & \\ \cline{1-1}  & & & Work conditions can lead to a loss of & \\ \cline{1-1}  & & purpose, social isolation, and stress. & [76; 77] \\ \hline \end{tabular}
\end{table} 
Table 1: Summary of the dimensions of multidimensional depression. There are three dimensions of a socioeconomic nature. The economic dimension is particularly relevant, as social disparities are directly linked to depression [64; 69]. Individuals with higher incomes have greater access to healthcare and, consequently, greater access to mental health services [65] and other services that promote health and well-being, such as assistance with healthy eating, which reduces the risk of severe depression [82]. The social habits dimension, comprising the use of substances such as alcohol and tobacco, includes important factors in understanding depression. Excessive alcohol consumption increases negative feelings such as sadness, hopelessness, and social isolation, increasing an individual's risk of developing symptoms of depression [66]. In turn, individuals who consume excessive nicotine are more likely to develop symptoms of depression as this substance influences the chemical balance in the brain [66]. Finally, the likelihood of developing symptoms of depression is lower for individuals who practice sports [67; 83] or own pets [68; 84]. Social determinants, including one's place of residence (geography), are indirectly associated with depression through socioeconomic and cultural factors, providing important information in terms of defining and implementing public policies and allocating resources to care for the population diagnosed with depression [69; 70]. There are four demographic dimensions. The educational dimension is crucial in understanding depression, given its direct relationship with other dimensions, such as economic status and location of residence, which impact an individual's ability to access mental health services [71; 72]. The gender dimension is also directly related to depression [74]. Research reveals that the prevalence of depression in women is higher than in men of the same age group [73]. The age dimension is directly related to depression. Neurobiological changes, loss of loved ones, and social isolation due to age are associated with increased vulnerability to depression [75]. This condition places age as a significant dimension in measuring depression. The employment dimension includes important factors in understanding depression.