Association between neighborhood social cohesion and depressive symptoms: findings from the CRONICAS Cohort Study

While the protective role of neighborhood social cohesion against mental disorders is well-documented in high-income countries, evidence from resource-constrained settings remains scarce. This study evaluated the cross-sectional and longitudinal associations between neighborhood social cohesion and depressive symptoms in a Peruvian cohort.

Data from the CRONICAS Cohort Study were analyzed. The primary outcomes were the prevalence and incidence of depressive symptoms, assessed via the Center for Epidemiologic Studies Depression Scale (CES-D). Neighborhood social cohesion, conceptualized through trust, reciprocity, and solidarity, was measured using a 4-item scale and categorized into tertiles. Single variable and multivariable-adjusted Poisson regression models were used to estimate incidence rate ratios (IRR) and 95% confidence intervals (95% CI).

Among 3533 participants (mean age 55.8 ± 12.7 years; 51.5% female), baseline prevalence of depressive symptoms was 18.6% (95%CI: 17.3%-19.9%). Middle and high levels of social cohesion were associated with a 27% (95% CI: 13%-38%) and 47% (95% CI: 19%-66%) lower prevalence of symptoms at baseline. We identified 221 incident cases (4.0 cases per 100 person-years, 95% CI: 3.5-4.6). High social cohesion was associated with an adjusted 46% (95% CI: 9%-68%) reduction in the risk of developing depressive symptoms over 30 months.

Higher neighborhood social cohesion was significantly associated with a reduced prevalence and a lower incidence of developing depressive symptoms. These findings suggest that interventions aimed at fostering community trust and social capital may represent a viable strategy for mental health prevention in resource-constrained environments.