Social network structure and depression by gender in rural Honduras: a cross-sectional study

Objectives: To assess the relationship between the structural position of individuals within their village network and symptoms of depression and postpartum depression, among men and women.

Design: Community-based, observational, cross-sectional study.

Setting: 176 villages in the Copan region of Honduras.

Participants: Village residents, comprising 25 605 adults surveyed in a census-based study; using data collected between October 2015 and December 2019.

Outcomes: Symptoms of depression and postpartum depression, among men and women.

Results: Across all participants, 34.99% reported depression symptoms (40.50% for women and 27.62% for men). Among recent parents with a new child in the last 6 months, 28.89% reported postpartum depression symptoms (31.29% for women and 24.31% for men). Women with higher social intransitivity (ie, a greater proportion of friend-pairs among their friends that were not themselves connected) had higher odds of depression symptoms (OR=1.27, 95% CI 1.14 to 1.41), an association not found for men nor in postpartum parents. Because this coefficient is estimated on a 0-1 scale, it corresponds to approximately 2.4% higher odds of depression per 10 percentage-point increase in social intransitivity. In a signed-network decomposition that also included adversarial ties, only the proportion of incomplete/no-tie friend-pairs was associated with depression in women (OR=1.03, 95% CI 1.01 to 1.04), corresponding to approximately 3% higher odds of depression per 10 percentage-point increase.

Conclusions: We report that structural social network position and connectedness beyond dyadic ties, including the friendships and adversarial ties of a person's friends, are associated with depression. These findings highlight the importance of linking psychological health to broader social connections in the context of face-to-face relationships.