Antidepressant use in spatial social networks

Abstract

Social networks may help individuals maintain their mental health. Most empirical work based on small-scale surveys finds that cohesive social networks are critical for mental well-being, while diverse networks are considered less important. Here, we link data on antidepressant use of 277,344 small-town residents to a nationwide online social network. The data enable us to examine how individuals' mental health care is related to the spatial characteristics of their social networks including their ties in the local community and connections to distant communities. We find that, besides the cohesion of social networks around home, the diversity of connections to distant places is negatively correlated with the probability of antidepressant use. Spatial diversity of social networks is also associated with decreasing dosage in subsequent years. This relationship is independent from the local access to antidepressants and is more prevalent for young individuals. Structural features of spatial social networks are prospectively associated with depression treatment.

Fig. 1.. Preparation and geographies of the data.

(A) A nationwide dataset of antidepressant prescriptions is linked to the OSN of small-town residents in Hungary at the individual level. (B) Hometowns of analyzed individuals and geographies of their social networks and local ratio of antidepressant users.

Fig. 2.. Spatial social network variables.

(A) Ego’s network structure is characterized by the LC of social network within ego’s town and by the SD of connections across towns. (B) The probability of taking antidepressants is lower for individuals who have above-median SD. (C) The average dosage of antidepressants in our patient sample is decreasing over the observed period. (D) The decreasing correlation over the years signals that individual dosage is changing.

Fig. 3.. Local cohesion and spatial diversity of social networks can predict antidepressant use.

(A) Spatial network structure predicts the probability of antidepressant use compared to randomized outcome (placebo). Coefficients of variables standardized to ζ-scores and 95% confidence intervals are plotted. (B) Local cohesion loses significance as spatial diversity increases. Coefficients of variables standardized to ζ-scores and 95% confidence intervals are plotted.