Social aspects of depression

Depression is a common and disabling mental disorder, affecting more than 200 million people worldwide. The social impact of illness is relevant in terms of frequency, severity and disability, comorbidity, costs, and impact on family life. Its aetiopathogenesis includes biological, psychological, and social factors, as integrated in the biopsychosocial model. In fact, several social risk factors have been identified for mood disorders and a relevant number of clinical disorders are sub-syndromal and mostly related to social maladjustment. The concept of depressive threshold is debated in the international literature. In addition, culture is a relevant factor influencing the explanatory model of illness, as well as its presentation and outcome. Depression heavily affects individual social functioning, and a set of psychological and social interventions are needed to address the social disability properly and family burden. The chapter concludes that the understanding and treatment of depression should be routinely based on a social medicine approach.