Childhood Sexual Abuse and the Development of Recurrent Major Depression in Chinese Women

Background Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set? Method Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. Results We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19–5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58–3.15), genital (OR 5.24, 95% CI 3.52–8.15) and intercourse (OR 10.65, 95% CI 5.56–23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11–2.27) and phobia (OR 1.41, 95%CI 1.09–1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20–1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02–2.02). Intercourse (OR 3.47, 95%CI 1.66–8.22), use of force and threats (OR 1.95, 95%CI 1.05–3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20–1.64) were significantly associated with recurrent MD

Carta de Pere Pascual al Dr. J. Ros (Oxford) concedint-li ajuda del GIFT per a desplaçar-se una setmana al CERN

Background Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set? Method Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. Results We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19–5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58–3.15), genital (OR 5.24, 95% CI 3.52–8.15) and intercourse (OR 10.65, 95% CI 5.56–23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11–2.27) and phobia (OR 1.41, 95%CI 1.09–1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20–1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02–2.02). Intercourse (OR 3.47, 95%CI 1.66–8.22), use of force and threats (OR 1.95, 95%CI 1.05–3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20–1.64) were significantly associated with recurrent MD. Conclusions In Chinese women CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA. Depressed women with CSA have some specific clinical traits. Some features of CSA were associated with greater likelihood of developing recurrent MD

The relationship between childhood sexual abuse (CSA) and clinical features of major depression (MD).

<p>Model 1 includes variables that reflect age and educational background. Model 2 includes in addition parental family history of depression. Model 3 includes in addition parent–child relationship, childhood physical abuse (CPA) and childhood emotional neglect CEN).</p><p>a The results from a linear regression model with age of onset of MD as response and with ‘any CSA’ as predictor.</p><p>b The results from a Poisson regression model with numbers of episodes of MD as response and with ‘any CSA’ as predictor.</p><p>c The results from a Poisson regression model with duration of the longest episodes of MD as response and ‘any CSA’ as predictor.</p

Childhood sexual abuse (CSA) and the odds ratios for co-morbid disorders.

<p>MD, major depression; GAD, generalized anxiety disorder; PD, panic disorder.</p><p>Values are given as n (%) or odds ratio (95% confidence interval).</p><p>Model 1 includes control variables for age and educational background. Model 2 includes in addition parental family history of depression. Model 3 includes in parent–child relationship as assessed by the PIB, childhood physical abuse (CPA) and childhood emotional neglect (CEN).</p>*<p><i>p</i><0.05, ** <i>p</i><0.01, *** <i>p</i><0.001.</p

Childhood sexual abuse (CSA) of all participants.

<p>Values are given as n (%).</p>***<p><i>p</i><0.001.</p

Characteristics of sexual abuse in major depression (MD) patients and controls who reported childhood sexual abuse (CSA).

<p>Values are given as n (%) and odds ratio (95% confidence interval).</p>*<p><i>p</i><0.05, ** <i>p</i><0.01, *** <i>p</i><0.001.</p

Association of Childhood sexual abuse (CSA) major depression (MD) symptoms.

<p>Values are given as odds ratio (95% confidence interval).</p>*<p><i>p</i><0.05, ** <i>p</i><0.01, *** <i>p</i><0.001.</p

Childhood sexual abuse (CSA) and the odds ratios for major depression (MD).

<p>Values are given as odds ratio (95% confidence interval).</p><p>Model 1 includes control variables for age and educational background. Model 2 includes in addition parental family history of depression. Model 3 includes in parent–child relationship as assessed by the the PIB, childhood physical abuse (CPA) and childhood emotional neglect (CEN).</p>*<p><i>p</i><0.05, ** <i>p</i><0.01, *** <i>p</i><0.001.</p><p>Cohort 1: MD n = 1920, Controls n = 2588; Cohort 2: MD n = 4041, Controls n = 3439; Combined: MD n = 5295, Controls n = 5820.</p