Major depressive disorder and perceived social support: Moderated mediation model of security and brain dysfunction

Low social support increases the risk of Major depressive disorder (MDD), yet its effects on brain function are unclear. Thirty-two MDD patients with low social support, 52 with high social support, and 54 healthy controls were recruited. We investigated regional brain activity in MDD patients with low social support using restingstate functional Magnetic Resonance Imaging, employing measures such as degree centrality (DC), regional homogeneity, amplitude of low-frequency fluctuations, and fractional amplitude of low-frequency fluctuations. Abnormal regions identified in these analyses were selected as regions of interest for functional connectivity (FC) analysis. We then explored relationships among social support, brain dysfunction, MDD severity, and insecurity using partial correlation and moderated mediation models. Our findings reveal that MDD patients with low social support show decreased DC in the right superior temporal pole and right medial geniculate nucleus, coupled with increased FC between the right superior temporal pole and right inferior temporal gyrus, and the right supramarginal gyrus compared to those with high social support. Furthermore, the DC of the right medial geniculate nucleus positively correlates with social support, while the FC between the right superior temporal pole and right supramarginal gyrus negatively correlates with both social support and subjective support. Additionally, a moderated mediation model demonstrates that the FC between the right superior temporal pole and right supramarginal gyrus mediates the relationship between social support and depression severity, with security moderating this mediation. These findings underscore the impact of low social support on brain function and depression severity in MDD patients.