Socioeconomic Determinants in Depression: Insights from a Unani Clinical Trial

Background: Socioeconomic status (SES) is increasingly recognized as a key determinant of mental health outcomes, particularly depression. This study, conducted at a government healthcare facility, examined the socioeconomic profile of patients with mild to moderate depression and evaluated its association with clinical severity and response to treatment using a classical Unani formulation. Methods: Eighty patients diagnosed with major depressive disorder (MDD) were enrolled in an open clinical trial assessing the efficacy of Sharbat Ahmad Shahi administered orally 20 ml twice daily for 6 weeks. Patients were stratified using Kuppuswamy’s Socioeconomic Status Scale (KSSES). Depression severity was measured at baseline and post-treatment using the Hamilton Depression Rating Scale (HDRS-17). Safety parameters, including hematological profiles and serum brain-derived neurotrophic factor (BDNF) levels, were assessed. Statistical analyses included paired t-tests, Pearson correlation, and ANOVA. Results: The majority of patients (72.5%) belonged to lower-middle (Class III, 30%) and upper-lower (Class IV, 42.5%) SES categories. A weak inverse correlation was observed between KSSES and baseline HDRS scores (r = -0.2799, p < 0.05) and between income scores and baseline HDRS (r = -0.2910, p < 0.01). No significant associations were found between debt amount/duration and depression severity or remission. Post-treatment HDRS scores improved significantly (p < 0.001), with 28 cases achieving remission (HDRS ≤ 7) and 50% response rate (≥50% reduction). SES did not influence therapeutic response. Conclusion: Depression impacts lower SES groups, consistent with public healthcare utilization patterns in India. While SES weakly correlates with baseline severity, it does not affect response to Sharbat Ahmad Shahi. These findings highlight the need for socioeconomic-informed mental health strategies in public sector settings.