Pathways to connection: Mapping the impact of social connection interventions on depression outcomes – an umbrella review

Introduction Social connection (SC) encompasses multiple dimensions, including structural and functional aspects of social relationships. While substantial evidence highlights the relationship between different SC metrics and depression, the effectiveness of interventions aimed at enhancing SC to alleviate depressive symptoms remains inadequately understood. Objectives This umbrella review combines evidence from systematic reviews to evaluate the effectiveness of SC interventions in alleviating depression. It specifically examines interventions that strengthen natural social networks, while excluding formal health-based interventions - such as psychosocial or psychotherapeutic treatments - designed to enhance social skills or deliver formal or semi-formal support within healthcare settings. Methods This review synthesizes the consistency and the extent of the impact of SC interventions on depression. PubMed, Cochrane Library, EMBASE, and PsycINFO were searched, resulting in the inclusion of 12 systematic reviews/meta-analyses. AMSTAR-2 and GRADE instruments were used to assess the quality and certainty of the evidence reviewed. Results Interventions were grouped into three categories: i) Social network and support interventions; ii) Social engagement interventions; iii) Social inclusion interventions. Findings were mixed, with some interventions demonstrating minimal/no effect compared to usual care. Interventions addressing social disengagement and promoting social integration for older individuals and psychiatric patients showed substantial improvements in outcomes. Social inclusion interventions aimed at strengthening group identification in adolescents and young adults also showed positive outcomes. Conclusions SC is a key determinant of depression. Further examination of targeted interventions is needed to determine which are most effective in influencing the evolving psychopathology of depressive trajectories. This may help identify targeted interventions for those at risk, thereby informing and guiding public health policies.