title: Stress across the life course and depression in a rapidly developing population: the Guangzhou Biobank Cohort Study.
abstract: OBJECTIVE
  The objective of this study was to examine the role of stress across the life course in the development of depression among older adults in a non-Western developing setting.
  
  
  METHODS
  Multivariable linear and multinomial logistic regression were used in cross-sectional analyses of 9729 Chinese participants (mean age 60.2 years) from phase 3 of the Guangzhou Biobank Cohort Study (2006-2008) to investigate the association of childhood adversities and adulthood stressors with depression.
  
  
  RESULTS
  Childhood adversities were associated with mild depression (odds ratio (OR) 1.78, 95% confidence interval (CI) 1.58, 2.02) and moderate-to-severe depression (OR 2.30, 95% CI 1.68, 3.15), adjusted for age, sex, education and childhood socio-economic status. Past-year adulthood stressors were also associated with mild depression (OR 1.96, 95% CI 1.54, 2.02) and moderate-to-severe depression (OR 3.55, 95% CI 2.21, 5.68), adjusting additionally for occupation and income. Adulthood stressors were more strongly associated with depressive symptoms among individuals with a history of childhood adversities.
  
  
  CONCLUSIONS
  Childhood adversities and adulthood stressors were independently associated with an increased risk of depression among older ambulatory adults, although adulthood stressors were more strongly associated with depression following exposure to childhood adversities. This is consistent with evidence from Western settings in which the social context of risk and protective factors for depression may differ and implies that the role of stress in the aetiology of depression is not context specific.
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Michael Y
authors.identifier: http://orcid.org/0000-0002-1217-5858
authors.initials: MY
authors.lastname: Ni
authors.affiliation: Guangzhou Number 12 Hospital, Guangzhou, China.
authors.forename: Chaoqiang
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK.
authors.forename: Kar Keung
authors.initials: KK
authors.lastname: Cheng
authors.affiliation: Guangzhou Number 12 Hospital, Guangzhou, China.
authors.forename: Weisen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.|Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gilman
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Leung
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.|School of Public Health, Hunter College and CUNY, New York, NY, USA.
authors.forename: C Mary
authors.initials: CM
authors.lastname: Schooling
mesh_terms: D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D003906:Developing Countries; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000453:epidemiology
keywords: childhood adversity; depression; life change events; life stress