Signe Kirk Dahl1, Janne Tidselbak Larsen2, Liselotte Petersen2, Mads Bonde Ubbesen3, Preben Bo Mortensen4, Trine Munk-Olsen2, Katherine Louise Musliner5. 1. The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark. 2. The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark. 3. The National Institute for Municipalities' and Regions' Analyses and Research, KORA, Denmark. 4. The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark; Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark. 5. The National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Denmark; iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark. Electronic address: klm@econ.au.dk.
Abstract
BACKGROUND: Early adversity is a known risk factor for unipolar depression. We examined the impact of 9 types of early adversity on risk for moderate to severe unipolar depression in adolescence or adulthood, and evaluated whether these effects were moderated by gender and adversity timing. METHODS: We conducted a prospective, population-based cohort study using Danish national registers. The sample included all individuals born in Denmark between 1980 and 1998 (N=978,647). Exposure to early adversity was assessed from ages 0-15. Types of adversity included parental illness, incarceration, death, disability, and psychiatric diagnosis; family disruption; out-of-home care; and childhood abuse. Individuals were followed from age 15 until first in- or outpatient depression diagnosis (ICD-10 codes F32, F33) in a psychiatric hospital, death, emigration, or December 31st, 2013, whichever came first. Hazard ratios (HRs) were calculated using Cox regressions. RESULTS: All adversities were significantly associated with increased risk for moderate to severe adolescent/adult depression (HR range: 1.30-2.72), although the effects were attenuated after mutual adjustment (adjusted HR range: 1.06-1.70). None of the effects were moderated by gender. The effect of family disruption was strongest between ages 0-4 (HR=1.66, 95% CI=1.61-1.71), while the effect of out-of-home care was strongest between ages 10-14 (HR=2.45, 95% CI=2.28-2.64). LIMITATIONS: Untreated and primary-care treated depression were not measured. CONCLUSIONS: Our results support past findings that multiple types of early adversity increase risk for moderate to severe unipolar depression in adolescence and adulthood. Certain adversities may be more harmful if they occur during specific developmental time periods.
BACKGROUND: Early adversity is a known risk factor for unipolar depression. We examined the impact of 9 types of early adversity on risk for moderate to severe unipolar depression in adolescence or adulthood, and evaluated whether these effects were moderated by gender and adversity timing. METHODS: We conducted a prospective, population-based cohort study using Danish national registers. The sample included all individuals born in Denmark between 1980 and 1998 (N=978,647). Exposure to early adversity was assessed from ages 0-15. Types of adversity included parental illness, incarceration, death, disability, and psychiatric diagnosis; family disruption; out-of-home care; and childhood abuse. Individuals were followed from age 15 until first in- or outpatientdepression diagnosis (ICD-10 codes F32, F33) in a psychiatric hospital, death, emigration, or December 31st, 2013, whichever came first. Hazard ratios (HRs) were calculated using Cox regressions. RESULTS: All adversities were significantly associated with increased risk for moderate to severe adolescent/adult depression (HR range: 1.30-2.72), although the effects were attenuated after mutual adjustment (adjusted HR range: 1.06-1.70). None of the effects were moderated by gender. The effect of family disruption was strongest between ages 0-4 (HR=1.66, 95% CI=1.61-1.71), while the effect of out-of-home care was strongest between ages 10-14 (HR=2.45, 95% CI=2.28-2.64). LIMITATIONS: Untreated and primary-care treated depression were not measured. CONCLUSIONS: Our results support past findings that multiple types of early adversity increase risk for moderate to severe unipolar depression in adolescence and adulthood. Certain adversities may be more harmful if they occur during specific developmental time periods.
Authors: S Meltzer-Brody; J T Larsen; L Petersen; J Guintivano; A Di Florio; W C Miller; P F Sullivan; T Munk-Olsen Journal: Depress Anxiety Date: 2017-11-24 Impact factor: 6.505
Authors: Erin C Dunn; Kristen Nishimi; Alexander Neumann; Alice Renaud; Charlotte A M Cecil; Ezra S Susser; Henning Tiemeier Journal: J Am Acad Child Adolesc Psychiatry Date: 2019-05-10 Impact factor: 8.829
Authors: Sara K Wood; Kat Ford; Hannah C E Madden; Catherine A Sharp; Karen E Hughes; Mark A Bellis Journal: Int J Environ Res Public Health Date: 2022-07-21 Impact factor: 4.614
Authors: Titik Juwariah; Fendy Suhariadi; Oedojo Soedirham; Agus Priyanto; Erni Setiyorini; Auliasari Siskaningrum; Heni Adhianata; Angelina da Costa Fernandes Journal: J Public Health Res Date: 2022-08-28
Authors: Mark A Bellis; Karen Hughes; Kat Ford; Gabriela Ramos Rodriguez; Dinesh Sethi; Jonathon Passmore Journal: Lancet Public Health Date: 2019-09-03