Social functioning in major depressive disorder

Abstract

Depression is associated with social risk factors, social impairments and poor social functioning. This paper gives an overview of these social aspects using the NIMH Research and Domain Criteria 'Systems for Social Processes' as a framework. In particular, it describes the bio-psycho-social interplay regarding impaired affiliation and attachment (social anhedonia, hyper-sensitivity to social rejection, competition avoidance, increased altruistic punishment), impaired social communication (impaired emotion recognition, diminished cooperativeness), impaired social perception (reduced empathy, theory-of-mind deficits) and their impact on social networks and the use of social media. It describes these dysfunctional social processes at the behavioural, neuroanatomical, neurochemical and genetic levels, and with respect to animal models of social stress. We discuss the diagnostic specificity of these social deficit constructs for depression and in relation to depression severity. Since social factors are importantly involved in the pathogenesis and the consequences of depression, such research will likely contribute to better diagnostic assessments and concepts, treatments and preventative strategies both at the diagnostic and transdiagnostic level.

Social functioning in patients with depressive and anxiety disorders

“…As described, impaired social functioning is highly associated with anxious and depressive symptomatology, although the underlying pathophysiological mechanisms remain largely elusive 49, 50. One possible explanation is that social interactions might be appreciated as less rewarding in anxious or depressed patients, due to impaired signaling of brain's reward system, in which the amygdala is crucially implicated 51.…”

“…One possible explanation is that social interactions might be appreciated as less rewarding in anxious or depressed patients, due to impaired signaling of brain's reward system, in which the amygdala is crucially implicated 51. This inability to gain reward from social interactions may lead to anhedonia symptoms 49. Future studies focusing specifically on the ‘social brain’, including the social reward system, could greatly advance our understanding of the underlying pathomechanisms of impaired social functioning.…”

Increased neural response to social rejection in major depression

“…These findings highlight the importance of studying social interactions in depression, as they often lead to social withdrawal and isolation. anhedonic individuals often derive little enjoyment from interpersonal interaction, report social disinterest and reduced motivation to belong to a social group, and in addition, often report that such experiences are both stressful and anxiety-provoking (Kupferberg, Bicks, & Hasler, 2016). …”

Puerarin ameliorated the behavioral deficits induced by chronic stress in rats

“…Major depressive disorder (MDD) is a debilitating and chronic disorder with high probability of medical and psychiatric co-morbidity, functional impairment, as well as significant societal and personal costs 1, 2 . Although several novel drug targets have been identified, there are no major breakthroughs in the treatment of the disorder 3 .…”