What is the impact of depression and socioeconomic status on socioeconomic decision-making: a systematic review and meta-analysis

Background Both depression and socioeconomic status (SES; including income, education, occupation, and subjective social standing) are thought to influence socioeconomic decision-making, yet their effects remain poorly understood. Using rejection of unfair offers in the Ultimatum Game (UG) as a behavioral index, this review synthesizes existing evidence on how depression and SES shape fairness-related decision-making and proposes directions for future research. Methods We searched PubMed, PsycINFO, Web of Science, and Google Scholar for peer-reviewed articles published up to June 2026. Eligible studies used the UG or UG-like paradigms and examined either depression or SES in relation to unfair-offer rejection. We summarized the included studies narratively and conducted separate random-effects meta-analyses for depression-related and SES-related effects on unfair-offer rejection. Results Eighteen studies were included: eleven depression-only studies, six SES-only studies, and one study examining both depression and SES. Depression-related studies showed mixed findings, including higher rejection, lower rejection, and no significant association with unfair-offer rejection. SES-related studies also produced inconsistent results, and the existing evidence does not support a uniform effect of SES on unfair-offer rejection. Meta-analyses showed non-significant pooled effects for both depression and SES. Heterogeneity was significant in the depression meta-analysis, while in the SES meta-analysis I ² was high despite a non-significant Q -test, likely reflecting limited statistical power given the small number of studies. Conclusion Current evidence does not support a simple conclusion that depression or SES uniformly increases or decreases rejection of unfair offers in the UG. Instead, their effects appear heterogeneous and context-dependent, possibly reflecting differences in clinical status, symptom severity, SES operationalization, task design, and cognitive-affective mechanisms such as fairness appraisal and emotional responses to unfairness. Direct empirical work jointly examining depression and SES remains limited. Future studies should use standard behavioral UG paradigms and clearly defined clinical and socioeconomic measures to test how depression and SES may jointly shape fairness-related decision-making.