Abstract：
There is a growing recognition of the impact of social determinants of mental health (SDoMHs) on people with, or at risk of, developing serious mental illnesses. Yet it is not known how associations of individual SDoMHs with risk for major depressive disorder (MDD) vary and roughly compare with one another. Following PRISMA guidelines, this umbrella review included 26 meta-analyses and systematic reviews that reported odds ratios, effect sizes, and/or pooled prevalence rates of MDD in samples with versus without specified SDoMHs. Childhood emotional, physical, or sexual abuse and neglect; intimate partner violence in females; and food insecurity were significantly associated with increased risk of MDD, with medium effect sizes. Natural disasters, terrorist acts, and military combat during deployment had small-size adverse effects, and homelessness, incarceration, and migration were associated with significantly elevated prevalence of MDD. Conversely, higher levels of parental care were significantly associated with reduced risk of MDD with medium effect sizes. Evidence supports the use of certain interventions at the individual and community level that can reduce the impact of these factors and promote health, although much more research is warranted in this area along with meaningful healthcare and societal policies to accomplish this goal.
摘要：
人们越来越认识到心理健康的社会决定因素（SDoMHs）对人们的影响，或者有风险，发展严重的精神疾病。然而，尚不清楚单个SDoMHs与重度抑郁症（MDD）风险的关联如何变化，并大致相互比较。按照PRISMA准则,这篇综述包括26项荟萃分析和系统综述，报告了比值比，效果大小,和/或有与无指定SDoMHs的样本中MDD的合并患病率。童年的情感，物理，或性虐待和忽视；女性亲密伴侣暴力；粮食不安全与MDD风险增加显著相关，具有中等效果尺寸。自然灾害,恐怖主义行为,部署期间的军事战斗产生了小规模的不利影响，无家可归，监禁,迁移与MDD患病率显著升高相关。相反，较高水平的父母照护与中等效应大小的MDD风险降低显著相关.证据支持在个人和社区层面使用某些干预措施，可以减少这些因素的影响并促进健康，尽管在这一领域需要更多的研究以及有意义的医疗保健和社会政策来实现这一目标。
