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?


METHODS
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.
Huashan Hospital of Fudan University, Shanghai, People's Republic of China.
Jing
J
Chen
Huashan Hospital of Fudan University, Shanghai, People's Republic of China.
Yiyun
Y
Cai
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Enzhao
E
Cong
The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Ying
Y
Liu
Chinese Traditional Hospital of Zhejiang, Hangzhou, Zhejiang, People's Republic of China.
Jingfang
J
Gao
No.1 Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Youhui
Y
Li
Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China.
Ming
M
Tao
No.1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.
Kerang
K
Zhang
ShengJing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Xumei
X
Wang
No. 1 Hospital of Medical College of Xian Jiaotong University, Xian, Shaanxi, People's Republic of China.
Chengge
C
Gao
Jilin Brain Hospital, Siping, Jilin, People's Republic of China.
Lijun
L
Yang
Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, People's Republic of China.
Kan
K
Li
Xian Mental Health Center, Xian, Shaanxi, People's Republic of China.
Jianguo
J
Shi
Beijing Anding Hospital of Capital University of Medical Sciences, Beijing, People's Republic of China.
Gang
G
Wang
Shandong Mental Health Center, Jinan, Shandong, People's Republic of China.
Lanfen
L
Liu
No. 3 Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
Jinbei
J
Zhang
Hebei Mental Health Center, Baoding, Hebei, People's Republic of China.
Bo
B
Du
Chongqing Mental Health Center, Chongqing, People's Republic of China.
Guoqing
G
Jiang
Tianjin Anding Hospital, Tianjin, People's Republic of China.
Jianhua
J
Shen
No.4 Hospital of Jiangsu University, Zhenjiang, Jiangsu, People's Republic of China.
Zhen
Z
Zhang
Psychiatric Hospital of Henan Province, Xinxiang, Henan, People's Republic of China.
Wei
W
Liang
Nanjing Brain Hospital, Nanjing, Jiangsu, People's Republic of China.
Jing
J
Sun
Harbin Medical University, Haerbin, Heilongjiang, People's Republic of China.
Jian
J
Hu
Shenzhen Kang Ning Hospital, Shenzhen, Guangdong, People's Republic of China.
Tiebang
T
Liu
First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Xueyi
X
Wang
Guangzhou Brain Hospital (Guangzhou Psychiatric Hospital), Guangzhou, Guangdong, People's Republic of China.
Guodong
G
Miao
No.1 Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Huaqing
H
Meng
Dalian No.7 Hospital, Dalian, Liaoning, People's Republic of China.
Yi
Y
Li
No.3 Hospital of Heilongjiang Province, Beian, Heilongjiang, People's Republic of China.
Chunmei
C
Hu
Wuhan Mental Health Center, Wuhan, Hubei, People's Republic of China.
Yi
Y
Li
Sichuan Mental Health Center, Mianyang, Sichuan, People's Republic of China.
Guoping
G
Huang
Mental Health Institute of Jining Medical College, Jining, Shandong, People's Republic of China.
Gongying
G
Li
Liaocheng No.4 Hospital, Liaocheng, Shandong, People's Republic of China.
Baowei
B
Ha
Mental Health Center of West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.
Hong
H
Deng
Suzhou Guangji Hospital, Suzhou, Jiangsu, People's Republic of China.
Qiyi
Q
Mei
Anhui Mental Health Center, Hefei, Anhui, People's Republic of China.
Hui
H
Zhong
Ningbo Kang Ning Hospital, Ningbo, Zhejiang, People's Republic of China.
Shugui
S
Gao
Changchun Mental Hospital, Changchun, Jilin, People's Republic of China.
Hong
H
Sang
No.2 Hospital of Lanzhou University, Lanzhou, Gansu, People's Republic of China.
Yutang
Y
Zhang
Fuzhou Psychiatric Hospital, Fuzhou, Fujian, People's Republic of China.
Xiang
X
Fang
Harbin No.1 Special Hospital, Haerbin, Heilongjiang, People's Republic of China.
Fengyu
F
Yu
Jining Psychiatric Hospital, Jining, Shandong, People's Republic of China.
Donglin
D
Yang
No.2 Xiangya Hospital of Zhongnan University, Changsha, Hunan, People's Republic of China.
Tieqiao
T
Liu
Xijing Hospital of No.4 Military Medical University, Xian, Shaanxi, People's Republic of China.
Yunchun
Y
Chen
Mental Health Center of Shantou University, Shantou, Guangdong, People's Republic of China.
Xiaohong
X
Hong
Tongji University Hospital, Shanghai, People's Republic of China.
Wenyuan
W
Wu
Huaian No.3 Hospital, Huaian, Jiangsu, People's Republic of China.
Guibing
G
Chen
Huzhou No.3 Hospital, Huzhou, Zhejiang, People's Republic of China.
Min
M
Cai
Mudanjiang Psychiatric Hospital of Heilongjiang Province, Mudanjiang, Heilongjiang, People's Republic of China.
Yan
Y
Song
No.1 Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China.
Jiyang
J
Pan
Qingdao Mental Health Center, Qingdao, Shandong, People's Republic of China.
Jicheng
J
Dong
Guangxi Longquanshan Hospital, Liuzhou, Guangxi, People's Republic of China.
Runde
R
Pan
Daqing No.3 Hospital of Heilongjiang Province, Daqing, Heilongjiang, People's Republic of China.
Wei
W
Zhang
Tangshan No.5 Hospital, Tangshan, Hebei, People's Republic of China.
Zhenming
Z
Shen
Anshan Psychiatric Rehabilitation Hospital, Anshan, Liaoning, People's Republic of China.
Zhengrong
Z
Liu
Weihai Mental Health Center, Weihai, Shandong, People's Republic of China.
Danhua
D
Gu
Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.
Xiaoping
X
Wang
Tianjin First Center Hospital, Tianjin, People's Republic of China.
Xiaojuan
X
Liu
Hainan Anning Hospital, Haikou, Hainan, People's Republic of China.
Qiwen
Q
Zhang
Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom.
Yihan
Y
Li
Clinical Trial Service Unit, Oxford, United Kingdom.
Yiping
Y
Chen
Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America.
Kenneth S
KS
Kendler
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China ; Huashan Hospital of Fudan University, Shanghai, People's Republic of China.
Shenxun
S
Shi
Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom.
Jonathan
J
Flint
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology* / Q000706:statistics & numerical data; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D019263:Dysthymic Disorder / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012008:Recurrence; D012307:Risk Factors