Abstract
Introduction: Major depressive disorder (MDD) is a disabling mental disorder with high global prevalence. While sedentary behavior (SB) has been consistently linked to adverse health outcomes, the influence of social determinants on SB in individuals with MDD, particularly from an intersectional perspective, remains underexplored. Objective: To investigate whether social determinants, analyzed intersectionality, are associated with the severity of depressive symptoms in adults with MDD, considering different levels of SB. Methods: A total of 108 adults (18-59 years) with a clinical diagnosis of MDD participated in an online survey. SB was assessed with the International Physical Activity Questionnaire. Depressive symptoms were measured with the Beck Depression Inventory. Social determinants were combined into a Jeopardy Index to classify participants into a dominant group and a minority group. Results: The association between social determinants and depression severity was moderated by SB level. In the low SB group, belonging to the minority group was associated with a higher proportion of moderate/severe depression (91.3% vs. 8.7%; p = 0.039) and a seven-fold increased risk for these symptoms (OR = 7.0; 95% CI: 1.27 - 38.47) compared to the dominant group. In contrast, no association was found in the high SB group. Conclusion: The intersectionality of social determinants was associated with depression severity in the low SB group. These findings reinforce the need for public health policies that consider social vulnerabilities to mitigate the impact of MDD, even in populations that do not exhibit high-risk sedentary behaviors.