Based on CHARLS2020 data, this study explored the association between social interaction and depressive symptoms in middle-aged and elderly people. The study found that the participation of middle-aged and elderly people in social interaction can reduce the occurrence of depressive symptoms. This may be related to the fact that social interaction can provide people with more social support and intimacy. When people are connected to those around them and feel cared for and supported by others, they are more likely to form a positive psychological state[22], thus reducing the risk of depression. In addition, social communication is also an important way for people to realize self-worth, recognition of others and enhance self-confidence. When people succeed in social interactions or receive positive feedback from others, it helps to increase their self-esteem and self-confidence, which reduces the occurrence of depressive symptoms[23]. On the other hand, social interaction also provides more opportunities and resources for middle-aged and elderly people. For example, when communicating and cooperating with others, people can acquire new knowledge, new skills and new life manifestations, which not only helps to improve the quality of life of individuals, but also helps to form positive life attitudes and ways to cope with pressure, and then reduce the negative emotions of middle-aged and elderly people, thus reducing the risk of depression symptoms in middle-aged and elderly people[24]. Therefore, we should strengthen community construction[25], enhance community cohesion, and organize various activities suitable for the middle-aged and elderly, such as square dancing, calligraphy and leisure running.
In terms of geographical distribution, the risk of depressive symptoms is higher in rural areas than in urban areas[26, 27], which may be because social networks in rural areas are different from those in urban areas, and people are more likely to rely on family and village groups for help and support. However, with the development of urbanization and the increase of population flow, the number of residents in rural areas has decreased and cohesion has weakened. Meanwhile, due to the lower economic level in rural areas and the lack of professional mental health services and treatment compared with urban areas, these factors may lead to the increased risk of depressive symptoms in middle-aged and elderly people in rural areas[28]. Therefore, in order to improve mental health in rural areas, it is necessary for the government and society to increase investment in mental health in rural areas and strengthen the construction of community support network.
In the realm of physiology, this study found that women had a higher risk of depressive symptoms than men, which was consistent with the results of Joan Domenech-Abella's study[29]. This may be due to the fact that women need to go through multiple special life cycles such as menstruation, pregnancy and menopause, and the changes in hormone levels in the body lead to mood swings and depressive symptoms[30]. At the same time, women are more sensitive than men and tend to internalize emotions, which leads to the accumulation of emotions and the occurrence of depression. At the same time, the role requirements and expectations of men and women are different in society, and women often assume family responsibilities such as taking care of families, children and elders, thus reducing social interaction activities with the outside world. These pressures make women feel cumbersome, disappointed and helpless in daily life, and thus increase the risk of depression. Therefore, attention should be paid to providing corresponding social support and resources for women, and increasing psychological monitoring for women in special periods, so as to help women better cope with emotional problems and depressive symptoms.
Regarding health factors, people with chronic diseases have a higher risk of depressive symptoms[31], which may be hampered by prolonged chronic diseases, which have adverse psychological effects on them, and then lead to the occurrence of depressive symptoms. Self-rated health is a widely used comprehensive subjective health evaluation index, so the better the self-rated health, the lower the risk of depressive symptoms. In terms of lifestyle, it is worth noting that the incidence of depression in non-smokers and non-drinkers is higher than that in smokers and non-drinkers. However, binary logistic regression analysis found that smoking has no statistical significance, while drinking is a protective factor for depression in middle-aged and elderly people, which is consistent with the research results of Xing Xianjin[32]. This may be because appropriate drinking can play a role in pleasing mood and promoting sleep to a certain extent[33].
To sum up, the current situation of depression in middle-aged and elderly people in China is not optimistic, and social communication can reduce the risk of depressive symptoms. Therefore, the government and relevant departments need to increase the construction of community and rural infrastructure to create a good place for promoting social communication between middle-aged and elderly people. At the same time, focus on women, unmarried, suffering from chronic diseases and low education level of people with depression, strengthen health publicity and education and mental health intervention; In addition, we should strengthen investment in unbalanced development areas such as rural areas, formulate relevant safeguard measures, and promote the equalization of basic public health services, so as to improve the mental health of middle-aged and elderly people, and then improve the quality of life and sense of gain of middle-aged and elderly people.
There are some limitations in this study: (1) The CESD-10 scale used by CHARLS to assess depression symptoms in middle-aged and elderly people is a self-report, which may have recall bias; (2) There are many factors affecting depression in middle-aged and elderly people, and this study may not cover all the influencing factors; (3) Although this study used a large sample of data from a reliable database, it excluded subjects that did not meet the criteria, which affected the extrapolation of the results to some extent.