Background
Methods
Inclusion criteria
Search strategy
Data extraction, quality assessment and synthesis
Results
Literature search
Eligible papers
Condition studied | Predictor variable | Outcomes | Sample size range (median) | Length of follow-upa | Follow-up rate range (median) | Quality score |
---|---|---|---|---|---|---|
Depression (n = 23) | Perceived social support (n = 22) Loneliness (n = 1) | Symptom severity (n = 13) Recovery/remission (n = 7) Functional outcomes (n = 5) | 66–604 (239) | Short (n = 4) Medium (n = 14) Long (n = 5) | 60.6–100% (81.9%) | **** (n = 4) *** (n = 11) ** (n = 8) |
Schizophrenia/schizoaffective disorders (n = 2) | Perceived social support (n = 2) | Functional outcomes (n = 2) | 139–148 (143.5) | Medium (n = 2) | 71.9–100% (86.0%) | *** (n = 1) ** (n = 1) |
Bipolar disorder (n = 4) | Perceived social support (n = 4) | Symptom severity (n = 3) Recovery/remission (n = 2) Functional outcomes (n = 2) | 42–173 (55.5) | Short (n = 1) Medium (n = 3) | 71.1–100% (86.4%) | *** (n = 2) ** (n = 2) |
Anxiety disorders (n = 3) | Perceived social support (n = 3) | Symptom severity (n = 1) Recovery/remission (n = 1) Functional outcomes (n = 1) | 134–1004 (1004) | Short (n = 1) Medium (n = 2) | 80–87% (81.0%) | **** (n = 1) *** (n = 1) ** (n = 1) |
Mixed samples with various mental health problems (n = 2) | Perceived social support (n = 1) Loneliness (n = 1) | Symptom severity (n = 1) Functional outcomes (n = 1) | 352–743 (547.5) | Medium (n = 2) | 79.9–84.4% (82.2%) | *** (n = 1) ** (n = 1) |
Depression
Reference | Predictor variable | Outcome variable | Results (++ < 0·05 adjusted; + < 0·05 unadjusted; − non-significant) | |
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Hybels et al. (2016) [79] | Perceived social support | Trajectory class (quick recovery, slow recovery, persistent moderate, and persistent high) | ++ | Patients in the persistent moderate depression class had lower levels of baseline subjective social support compared with patients in the quick recovery class (OR (95%CI) = 0.91 (0.83, 0.98)). Patients in the persistent high depression class had lower levels of baseline subjective social support compared with those in the quick recovery class (OR (95%CI) = 0.83 (0.75, 0.92)) |
Holvast et al. (2015) [25] | Loneliness | Symptom severity; Remission | ++ ++ | In the fully adjusted model, a 1-point higher baseline loneliness score predicted a 0·61-point higher depressive symptom severity score at follow-up (Beta = 0.61, 95% CI 0.12–1.11, p = 0.02). Logistic regression analysis showed that while adjusting for social network size and potential confounders, the very severely lonely respondents were less likely to achieve remission from their depressive disorder compared with the non-lonely respondents (OR = 0.25, 95% CI 0.08–0.80, p = 0.02). |
Holma et al. (2012) [54] | Perceived social support | Disability pensions | + | Lower perceived social support at baseline predicted greater likelihood of being granted a disability pension over 5 year follow-up on univariate analysis (p = 0.031), but not significant in multivariate analyses where the outcome was the interval time to the date the pension was granted |
Backs-Dermott et al. (2010) [80] | Perceived social support | Relapse versus stable remitted | ++ | Lower perceived social support from a significant other (standardized discriminant function coefficient 0.48) and lower perceived social support from friends (standardized coefficient 0.35) at baseline predicted greater likelihood of depressive relapse at one-year follow-up. The Discriminant Function Analysis was significant, Wilk’s Lambda = 0.69, x2 (5) = 16.35, p = 0.006 |
Bosworth et al. (2008) [81] | Perceived social support | Depression severity | ++ | Poorer subjective social support was a significant predictor of more severe depression at 12 months. Standardized beta = − 0.13, p = 0.05 |
Rytsala et al. (2007) [55] | Perceived social support | Work disability allowances | + | Lower perceived social support at 6 month was a significant predictor of greater likelihood of being granted disability allowances at 18 months (F = 6.3, p = 0.013), but not significant in multivariate analysis |
Rytsala et al. (2006) [56] | Perceived social support | Functional disability; Social and work adjustment; Days spent ill in bed or not | ++ ++ − | Lower perceived social support at baseline was a significant predictor of more severe functional disability at 6 months (B = 0.232, β = 0.210, p = 0.002, 95% CI 0.084 to 0.379), and poorer social and work adjustment at 6 months (B = − 0.008, β = − 0.222, p = 0.001, 95% CI -0.013 to − 0.003). Lower perceived social support at 6 months was one of the most significant factors predicting more severe functional disability at 18 months (B = 0.240, β = 0.215, p = 0.002, 95% CI 0.088 to 0.393), and poorer social and work adjustment at 18 months (B = − 0.011, β = − 0.303, p‹0.001, 95% CI -0.015 to − 0.006). But perceived social support did not predict any days spent ill in bed or not |
Leskela et al. (2006) [51] | Perceived social support | Severity of depression | + | Lower perceived social support at 6 months predicted more severe depression at 18 months in original zero-order correlation (r = − 0.392, p < 0.001) and within-group standardised correlation (r = − 0.230, p = 0.001) among all patients, but not significant in multivariate analysis. In full remission group at 6 months (n = 67), lower perceived social support at 6 months predicted higher level of depressive symptoms at 18 months in multivariate analysis (r = − 0.321, p = 0.012) |
Steffens et al. (2005) [82] | Perceived social support | Severity of depression | ++ | Lower subjective social support at baseline predicted more severe depression over time (estimate − 0.5641, p = 0.0002) |
Ezquiaga et al. (2004) [83] | Perceived social support | Episode remission | – | Higher perceived social support at baseline did not predict remission at 12 months in univariate analysis (p = 0.33), and it was not included in multivariate analysis |
Reference | Predictor variable | Outcome variable | Results (++ < 0·05 adjusted; + < 0·05 unadjusted; − non-significant) | |
Gasto et al. (2003) [84] | Perceived social support | Severity of residual symptoms | ++ | Lower subjective social support at baseline predicted higher intensity of residual symptoms at 9 months in remitters (standardized β = 0.41, p < 0.001) |
Bosworth et al. (2002) [53] | Perceived social support | Time-to-remission | ++ | Lower subjective social support at baseline (Hazard Ratio = 0.47, 95% CI: 0.31–0.71, p = 0.003) was a significant predictor of longer time to remission |
Bosworth et al. (2002) [52] | Perceived social support | Remission | ++ | Lower baseline levels of subjective social support (OR = 1.21, 95% CI: 1.09–1.35, p < 0.001) predicted poorer recovery one year later |
Triesch (2002) [85] | Perceived social support | Severity of depressive symptoms; Quality of life | − − | Lower perceived social support at baseline did not predict more severe depression (β = − 0.17) or poorer quality of life (β = − 0.12) at 3 months |
Hays et al. (2001) [57] | Perceived social support | Activities of daily living | ++ | There was modest support for hypothesis that baseline subjective social support predicted functional declines at 1 year. There was partial support for hypothesis that the buffering effects of social support against functional decline would be strongest among the most severely depressed patients |
Oxman and Hull (2001) [86] | Perceived social support | Depression severity | ++ | Greater perceived social support predicted subsequent decreases in depression among participants randomly assigned to placebo group (6-week depression − 0.18, p < 0.05; 11-week depression − 0.22, p < 0.05), but not significant among paroxetine group or Problem-Solving Treatment for Primary Care group |
Brummett et al. (2000) [87] | Perceived social support | Depressive symptoms | – | Higher levels of received support at baseline significantly predicted decreases in depressive symptoms at both 6 months and 1 year, whereas subjective support did not significantly predict changes in depressive symptoms at either point in time |
Sherbourne et al. (1995) [88] | Perceived social support | Number of depressive symptoms | ++ | Decreased number of depressive symptoms between baseline and 2-year follow-up was predicted by social support at baseline (standardised regression coefficients = 0.12, zero-order Pearson product-moment correlations = 0.16, p < 0.05). Among the subset of patients who had current depressive disorder at baseline, perceived social support was not significantly related to remission. Among patients without current depressive disorder at baseline (subthreshold depression), patients with higher level of perceived social support were less likely to experience a new depressive episode during 2-year period: odds ratio = 0.96 (CI:0.95, 0.98) |
Blazer et al. (1992) [49] | Perceived social support | Decreased life satisfaction symptoms; Endogenous symptoms | ++ | Impaired subjective support at baseline was predictive of poorer outcome at 12-month follow-up in both models: decreased life satisfaction symptoms (b = 0.10, B = 0.37, p ≤ 0.001), endogenous symptoms (b = 0.10, B = 0.30, p ≤ 0.01) |
Blazer et al. (1991) [89] | Perceived social support | Depressive symptoms | + | Intercorrelation between social support at baseline and depression score at 6 months: − 0.41, p < 0.001. Intercorrelation between social support at baseline and depression score at 12 months: − 0.34, p < 0.001 |
Brugha et al. (1990) [50] | Perceived social support | Symptom severity | ++ | After controlling for the two significant clinical predictors, a significant main effect was found in total sample for lower satisfaction with support at baseline on more severe psychiatric status at 4 months (regression coefficient = − 1.46, p < 0.05) |
George et al. (1989) [90] | Perceived social support | Depressive symptoms | ++ | Impaired subjective social support at baseline is a significant predictor of higher numbers of CES-D symptoms at follow-up (b = 8.88, B = 0.20, p ≤ 0.05) |
Krantz and Moos (1988) [91] | Perceived social support | Remitted, partially remitted, and nonremitted | + | Lower quality of relationships at baseline predicted poorer remission status after 1 year (χ2 = 10.21, p < 0.01) |
Schizophrenia/schizoaffective disorders
Reference | Predictor variable | Outcome variable | Results (++ < 0·05 adjusted; + < 0·05 unadjusted; − non-significant) | |
---|---|---|---|---|
Ritsner et al. (2006) [58] | Perceived social support | Quality of life | ++ | Higher friend support at baseline predicted better satisfaction with life quality after 16 months (accounted for 2.9% of quality of life index scores at follow up examination) |
Brekke et al. (2005) [59] | Perceived social support | Global functional outcome (work, social functioning, and independent living); Social functioning domain | − ++ | Higher social support did not significantly predict better global functional outcome at 12 months (p < 0.10). But social support became a much stronger and statistically significant predictor of social functioning domain |
Bipolar disorder
Reference | Predictor variable | Outcome variable | Results (++ < 0·05 adjusted; + < 0·05 unadjusted; − non-significant) | |
---|---|---|---|---|
Koenders et al. (2015) [60] | Perceived social support | Depressive symptomatology; Depression related functional impairment; Manic symptomatology; Manic related functional impairment | ++ ++ | Lower perceived support predicted more depression related functional impairment during the subsequent 3 months (β (SE) = − 0.14 (0.03), p < 0.001), and with more depressive symptomatology at the subsequent time point (β (SE) = − 0.14 (0.04), p = 0.002). No significant associations between perceived social support and manic symptoms and impairment were observed |
− − | ||||
Cohen et al. (2004) [63] | Perceived social support | Recurrence | ++ | After controlling for clinical variables, lower social support of any kind significantly predicted recurrence of any type at one year (β (SE) = − 0.09 (0.04), p = 0.03, OR = 0.92, 95% CI 0.85–0.99) |
Daniels (2000) [61] | Perceived social support | Depressive symptomatology; Manic symptomatology; Functional impairment | ++ ++ ++ | Lower perceived support was a significant predictor of more severe depressive symptomatology after controlling for initial levels of depression (R2 = 0.67, F = 34.15, ΔR2 = 0.05, ΔF = 5.24, beta = − 0.25). Lower perceived support significantly predicted more severe manic symptomatology over three months (R2 = 0.18, F = 3.74, ΔR2 = 0.10, ΔF = 4.18, beta = − 0.32). Lower perceived social support significantly predicted impairment in functioning in the participants who completed their life charts for 90 consecutive days, after controlling for initial levels of functional impairment (R2 = 0.44, F = 5.48, ΔR2 = 0.41, ΔF = 10.22, beta = − 0.67). |
Johnson et al. (1999) [62] | Perceived social support | Time to recovery; Severity of depressive symptoms; Severity of manic symptoms | ++ ++ − | Lower social support was a significant predictor of longer time to recovery in Cox regression survival analyses (χ2 (1, N = 52) change = 5.89, one-tailed p < 0.01). In hierarchical multiple regression analyses, low social support predicted higher depression over time (regression coefficient = − 1.33, p < 0.01, R2 change = 0.07, F change = 11.70). Social support did not have significant impact on mania score at 6-month follow-up |
Anxiety disorders
Reference | Predictor variable | Outcome variable | Results (++ < 0·05 adjusted; + < 0·05 unadjusted; − non-significant) | |
---|---|---|---|---|
Jakubovski and Bloch (2016) [64] | Perceived social support | Remission; Response (a reduction of at least 40% symptoms at 6 months) | ++ ++ | Generalised anxiety disorder: Greater amount of social support predicted a higher rate of remission (OR = 1.38, 95% CI Wald 1.09–1.75, p = 0.0067) and a greater rate of response (OR = 1.33, 95% CI Wald 1.10–1.62, p = 0.0040) at 6-month follow-up. Social anxiety disorder: Greater amount of social support predicted a higher rate of remission (OR = 1.716, 95% CI Wald 1.028–2.867, p = 0.0391) at 6-month follow-up, but social support did not predict response. Social support did not predict remission or response for panic disorder or post-traumatic stress disorder |
Shrestha et al. (2015) [65] | Perceived social support | Quality of life | ++ | Main effect of social support was significant such that those with higher baseline social support reported higher average quality of life over time (b (SE) = 0.41 (0.08), p < 0.001) |
Dour et al. (2014) [33] | Perceived social support | Anxiety symptoms; Depressive symptoms | ++ ++ | Direct effects: Relations between perceived social support and depression were bidirectional at all follow-ups, whereas they were unidirectional between perceived social support and anxiety at 6- and 12-month follow-ups. Indirect effects: Intervention led to changes in 6- and/or 12-month perceived social support, that in turn led to subsequent changes in 18-month depression (b = − 0.16, CI [− 0.28, − 0.08], Ratios 10.51%) and anxiety (b = − 0.15, CI [− 0.30, − 0.06], Ratios 8.85%) |
Mixed samples with various mental health problems
Reference | Predictor variable | Outcome variable | Results (++ < 0·05 adjusted; + < 0·05 unadjusted; − non-significant) | |
---|---|---|---|---|
Fleury et al. (2013) [67] | Perceived social support | Subjective quality of life | ++ | Social support variables at baseline accounted for 7.9% of quality of life at 18-month follow-up. Among social support dimensions, higher perception of availability of social integration (β = 0.196, t = 3.472, p = 0.001, 95% CI [0.942, 3.410]) and reassurance of worth supports (β = 0.136, t = 2.397, p = 0.017, 95% CI [0.255, 2.597]) at baseline predicted better quality of life at 18-month follow-up |
Van Beljouw et al. (2010) [66] | Loneliness | Severity of depression; Severity of anxiety | ++ + | A higher symptom severity in depression at 1-year follow-up was predicted by more loneliness at baseline in both multilevel univariate linear regression analyses (β = 0.89, SE = 0.17, p < 0.001) and multilevel multivariate linear regression analyses (β = 0.39, SE = 0.16, p < 0.05). Positive associations were found between more symptom severity in anxiety at 1-year follow-up and loneliness at baseline by multilevel univariate linear regression analyses (β = 0.40, SE = 0.12, p < 0.01) (but not significant in multivariate analyses) |