People with more geographically diverse social networks are less likely to use antidepressants

An analysis linking data on antidepressant use by nearly 300,000 small-town residents in Hungary with data on their nationwide social networks found that individuals with friends and acquaintances in distant places were less likely to use antidepressants. This pattern was particularly visible among younger individuals. The research was published in Science Advances.

Social capital refers to the networks of relationships among people in a society, enabling that society to function effectively. It encompasses levels of trust, mutual understanding, and shared values and behaviors that foster cooperation. High social capital typically means strong community ties and a sense of solidarity. It can offer both emotional and practical support to individuals.

Previous research has shown that social capital is strongly linked to mental health. Communities with higher social capital tend to have lower rates of mental health issues such as depression and anxiety. This protective effect is thought to stem from increased social support: people in such communities have more opportunities for meaningful engagement and are more likely to have someone to turn to during times of stress or crisis. Moreover, the sense of belonging and inclusion associated with social capital can buffer against psychological distress and enhance individuals’ self-worth and resilience.

Study author Balázs Lengyel and his colleagues aimed to investigate these associations further. They linked a nationwide dataset on antidepressant use by 277,344 small-town residents in Hungary to data on those individuals’ online social networks. Using this combined dataset, the researchers explored how certain structural features of social networks relate to mental health. Because depression is one of the most common mental health conditions, the use of antidepressant medication was treated as a proxy for mental health status (i.e., individuals with better mental health are less likely to be using antidepressants).

The data on antidepressant use came from the Hungarian National Healthcare Service Center and covered prescriptions filled through pharmacies between 2011 and 2015. (Data on antidepressant use during hospital care was not included.) Individuals who were not recorded as purchasing antidepressants were considered not to have used them. The analysis was limited to residents of settlements with populations between 5,000 and 20,000.

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The social network data came from publicly available profiles on the iWiW website. iWiW was a popular Hungarian social networking platform in the mid to late 2000s. Launched in 2002 as WiW (“Who is Who”), the site allowed users to create profiles, connect with friends, share photos, and send messages. By 2006, it had become the dominant social network in Hungary, peaking at around 4.5 million registered users—significant in a country with fewer than 10 million residents. However, with the rise of global platforms like Facebook, iWiW’s user base declined, and the service was officially shut down in 2014. For their analysis, the researchers included user profiles with more than zero but fewer than 5,000 connections, excluding accounts that were never accessed after registration.

The results showed that individuals with more cohesive local social networks were less likely to use antidepressants. Cohesion was calculated based on how interconnected a person’s friends were within their hometown, compared to what would be expected in a randomly generated network of the same size. In essence, individuals embedded in tightly knit local groups—likely to offer strong emotional support—had lower rates of antidepressant use.

The researchers also found that individuals who had social ties to people in distant towns were less likely to use antidepressants. These geographically diverse connections were associated with greater reductions in antidepressant dosage over the following years.

“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,” the study authors concluded.

The study sheds light on the links between characteristics of one’s social networks and the use of antidepressants. However, it is important to note that the study is correlational—it cannot determine whether diverse social networks cause better mental health or vice versa. It’s also based on data from small-town residents in Hungary, so the findings may not generalize to people in large cities or to individuals from other cultural contexts.

The paper, “Antidepressant use in spatial social networks,” was authored by Balázs Lengyel, Gergő Tóth, Nicholas A. Christakis, and Anikó Bíró.