Study of first-year doctors and recently widowed seniors shows social support has greatest impact on those with highest polygenic risk scores for depression

Reaching out to support someone when they are stressed is always a good idea. But a new study suggests support could be particularly important for someone whose genetic makeup makes them more likely to develop depression.

The study shows the importance of social support in cushioning the risk of developing symptoms of depression in general, using data from two very different groups of people under stress: new doctors during the most intense training year and the elderly whose spouses have recently died.

But the largest effect was seen in those with the most genetic variations that increased the risk of depression.

The article uses a measure of genetic risk called the polygenic risk score, which is based on decades of research into the tiny variations in specific genes linked to depression risk.

Compared to people in the study who had low polygenic risk scores for depression, doctors and widows with higher risk scores had higher rates of depression after losing social support, but also had lower rates. lower levels of depression when they received social support during times of stress.

The study, published in the American Journal of Psychiatry by a team from the University of Michigan, suggests that more could be done to target social support to those who can benefit the most.

Genes, stress and social connection

“Our data show great variability in the level of social support individuals received during these stressful times, and how that changed over time,” said first author Jennifer Cleary, MS, a doctoral student in psychology at UM researching with lead author Srijan. Sen, MD, Ph.D., of UM School of Medicine. “We hope that these results, which incorporate genetic risk scores as well as measures of social support and depressive symptoms, will shed light on gene-environment interactions and more specifically the importance of social connection in the risk of depression. »

Sen, director of the Eisenberg Family Depression Center and professor of psychiatry and neuroscience, adds that while genetic research is revealing more DNA variation linked to vulnerability to depression, it’s crucial to learn how this variation leads to the Depression.

“A better understanding of the different genetic profiles associated with susceptibility to loss of social support, lack of sleep, excessive work stress and other risk factors could help us develop personalized advice for the prevention of depression. “, did he declare. “In the meantime, these results reaffirm the importance of social connections, social support and individual sensitivity to the social environment as factors of well-being and prevention of depression. »

Different populations, similar models

The new study used data from two long-term studies that both capture genetic, mood, environmental and other data from populations of participating individuals.

One is the Intern Health Study, which recruits first-year medical residents (also called interns) from the United States and beyond, and which Sen directs.

The other is the Health and Retirement Study, based at UM’s Institute for Social Research and funded by the National Institute on Aging.

The data in the new paper comes from 1,011 trainees trained at hospitals across the country, almost half of whom were women, and 435 recently widowed people, 71% of them women, who had data from surveys conducted. before and after the death of their spouse. .

Among trainees, as Sen and his team have shown in previous work, depressive symptoms increased dramatically (126%) during the stressful training year that includes long and irregular working hours – often in environments away from friends and family.

In widows and widowers, depressive symptoms increased by 34% compared to their pre-widowhood scores. This correlates with previous research showing that the loss of a spouse can be one of the biggest stressors in a person’s life, Cleary said.

A cross effect

Next, the researchers considered the depression symptom scores with each person’s polygenic risk score for depression and their individual responses to questions about connections to friends, family and other social supports.

Most interns have lost the social support of their pre-internship days – which fits well with the common experience of leaving where they attended medical school and moving to a new environment where they may not know anyone.

Interns who had the highest polygenic risk scores and who also lost social support had the highest scores on measures of depression symptoms later in the stressful internship year.

However, those with the same level of high genetic risk who had obtained social support had much lower depressive symptoms. In fact, it was even lower than their low genetic risk peers, no matter what happened to their social support. Researchers call this a “crossover effect.”

Unlike interns, some widowed people reported an increase in social support after the loss of their spouse, potentially as friends and family reaching out to offer help or simply a listening ear.

But the cross-effect was also visible in them. Widows at high genetic risk for depression who gained social support showed a much smaller increase in depressive symptoms than their peers at similar genetic risk who lost social support after losing a spouse.

There were also widows who lost their social support or experienced no change in support, and whose depressive symptoms did not change. Cleary notes that in future work, it will be important to examine the history of this group in light of any caregiving they may have provided to a spouse with a long-term illness.

The team also hopes that other researchers will study this same interaction of genetic risk, stress and social support in other populations.

In the meantime, Cleary and Sen say, the message for anyone going through stressful times, or watching a friend or relative go through stressful times, is to reach out and maintain or strengthen social connections.

This can have benefits for both the person under stress and the person contacting them, they note.

Reducing the level of ongoing stress the person faces, whether at work, school, after a personal loss, or in family situations, can be essential.

And although the study did not examine the role of professional mental health help, individual and group therapy are important options for those who have developed depression or other mental health problems.

Note: The polygenic risk score used in the study is validated for use on people of primarily European ancestry, which limits the ability to generalize the results to people of other origins. Sen notes that additional work is underway using data from the Intern Health Study and the Health and Retirement Study to develop polygenic risk scores based on genetic traits linked to depression in other countries. populations, including people of East Asian and African descent.

In addition to Cleary and Sen, the authors of the study are Yu Fang, MSE, Laura B. Zahodne, Ph.D., Amy SB Bohnert, Ph.D., and Margit Burmeister, Ph.D., all of ‘ON THE. Zahodne, Bohnert and Burmeister are members of the Eisenberg Family Depression Center; Sen and Burmeister are members of the Michigan Neuroscience Institute; Sen and Bohnert are members of the UM Institute for Healthcare Policy and Innovation.

The study was funded by the National Institute of Mental Health (MH101459) and the National Institute of Child Health and Development (HD007109).

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