Functional and Structural Social Support in DSM-5 Mood and Anxiety Disorders: A Population-based Study

Background: Social support has been found to be a key correlate of many psychiatric disorders including several mood and anxiety disorders. However, research on social support is largely investigated in individual disorders, despite the high co-occurrence of these diagnoses, and has typically relied on pre-DSM-5 diagnostic criteria. Additionally, differences in structural and functional social support are rarely explored. Thus, the present study investigated the unique association between these two aspects of social support and past-year DSM-5 mood and anxiety disorders while adjusting for comorbidity and socio-demographic variables.

Methods: Multivariate regression and relative weights analyses were conducted to determine the association of functional and structural social support with these disorders in the National Epidemiologic Survey on Alcohol and Related Conditions consisting of 36,309 participants.

Results: Results indicated depression, bipolar I, social anxiety, generalized anxiety, and posttraumatic stress disorder were significantly associated with functional support, while depression and agoraphobia were uniquely associated with structural support. Major depression and persistent depression were the two most important predictors of functional social support.

Limitations: The current study utilized cross-sectional data and does not allow for causal or directional conclusions. Further, additional studies with diverse samples are needed to determine the generalizability of the current results.

Conclusions: This study highlights differences in functional and structural social support in various disorders and explores how this varies when accounting for comorbidity. A deeper understanding of how specific aspects of social support relate to individual psychiatric disorders could inform future prevention and treatment efforts.