Social Determinants and Depressive Symptoms: A Survey-Based Investigation of Depression Onset and Severity in Italy

Depression is a leading global health concern and is projected to become one of the major contributors to the global burden of disease in the coming decades. Increasing evidence highlights the role of social determinants-including socioeconomic conditions, social relationships, life stressors, discrimination, and environmental influences-in shaping the risk and clinical expression of depressive disorders. This study aimed to investigate social determinants associated with the presence and severity of depressive symptoms in Italian general population.

A cross-sectional survey was conducted among 1,036 adults from the Italian general population, recruited through personal networks and online platforms using snowball sampling. Participants completed a structured questionnaire assessing sociodemographic characteristics, social support, stressful life events, quality of life, minority stress experiences, social media use, environmental and societal concerns, substance use, and mental health symptoms. Comparative analyses were performed between individuals reporting a clinician-diagnosed depressive disorder (n = 143; 13.8%) and those without a diagnosis (n = 893).

Participants with a depressive disorder reported significantly higher exposure to multiple adverse social determinants. They were more likely to experience stressful life events, reduced perceived social support, poorer quality of life, minority stress, and negative psychosocial effects related to social media use. Concerns regarding broader socio-environmental issues, including political instability and climate change, were also more prevalent in the diagnosed group. These social vulnerabilities were accompanied by greater severity of depressive symptoms, anxiety-related manifestations, impulse-control difficulties, aggressive behaviors, and the use of substances as a coping strategy (all p ⩽ .003).

The findings support social determinants framework for understanding depression, highlighting the contribution of social adversity, environmental stressors, and relational factors to the development and severity of depressive symptoms. Population-based surveys can help identify vulnerable groups and inform preventive strategies and public health interventions aimed at addressing the social conditions that contribute to depression.