Changwei Li1, Toni Miles2, Luqi Shen3, Ye Shen4, Tingting Liu5, Mengxi Zhang6, Shengxu Li7, Cheng Huang8. 1. Assistant Professor of Epidemiology,Department of Epidemiology and Biostatistics,University of Georgia College of Public Health,USA. 2. Professor of Epidemiology, Department of Epidemiology and Biostatistics,University of Georgia College of Public Health,USA. 3. Predoctoral Research Fellow, Department of Epidemiology and Biostatistics,University of Georgia College of Public Health,USA. 4. Associate Professor of Biostatistics, Department of Epidemiology and Biostatistics,University of Georgia College of Public Health,USA. 5. Assistant Professor of Nursing,Department of Nursing,University of Arkansas College of Education and Health Professions,USA. 6. Postdoctoral Research Fellow,Department of Global Community Health and Behavioral Sciences,Tulane University School of Public Health and Tropical Medicine,USA. 7. Assistant Professor of Epidemiology, Department of Epidemiology,Tulane University School of Public Health and Tropical Medicine,USA. 8. Professor of Health Economics, School of Economics and Management,Harbin Institute of Technology (Shenzhen),China and Department of Global Health,George Washington University,USA.
Abstract
BACKGROUND: The Chinese Great Famine caused widespread starvation in 1959-1961. Its long-term association with depressive symptoms has not been studied.AimsTo estimate the burden of depressive symptoms and the association of famine exposure with depressive symptoms. METHOD: The China Health and Retirement Longitudinal Study is a nationwide representative survey of 17 708 Chinese adults aged ≥45. Propensity score matching and modified Poisson regression were used to evaluate the association between self-reported famine exposure in early life and depressive symptoms among the overall participants. Such associations were also assessed by developmental stage using modified Poisson regression and logistic regression. RESULTS: The prevalence of depressive symptoms was 26.2% (95% CI 25.1-27.3%) in 2011. As defined by loss of family members because of starvation, 11.6% (95% CI 10.1-13.1%) of this population experienced severe famine. When compared with participants who did not experience starvation, those who had experienced severe famine during fetal, mid-childhood, young-teenage and early-adulthood stages had 1.87 (95% CI 1.36-2.55), 1.54 (95% CI 1.23-1.94), 1.47 (95% CI 1.09-2.00) and 1.77 (95% CI 1.42-2.21) times higher odds of having depressive symptoms in late adulthood, respectively. The first two trimesters of pregnancy were a critical time window during the fetal stage when severe famine had a stronger association with depressive symptoms. Famine during infant, toddler, preschool or teenage stages was not associated with depressive symptoms. Overall, famine contributed to 13.6% of the depressive symptom burden in this population. CONCLUSIONS: The Chinese Great Famine contributed substantially to the burden of depressive symptoms in China.Declaration of interestNone.
BACKGROUND: The Chinese Great Famine caused widespread starvation in 1959-1961. Its long-term association with depressive symptoms has not been studied.AimsTo estimate the burden of depressive symptoms and the association of famine exposure with depressive symptoms. METHOD: The China Health and Retirement Longitudinal Study is a nationwide representative survey of 17 708 Chinese adults aged ≥45. Propensity score matching and modified Poisson regression were used to evaluate the association between self-reported famine exposure in early life and depressive symptoms among the overall participants. Such associations were also assessed by developmental stage using modified Poisson regression and logistic regression. RESULTS: The prevalence of depressive symptoms was 26.2% (95% CI 25.1-27.3%) in 2011. As defined by loss of family members because of starvation, 11.6% (95% CI 10.1-13.1%) of this population experienced severe famine. When compared with participants who did not experience starvation, those who had experienced severe famine during fetal, mid-childhood, young-teenage and early-adulthood stages had 1.87 (95% CI 1.36-2.55), 1.54 (95% CI 1.23-1.94), 1.47 (95% CI 1.09-2.00) and 1.77 (95% CI 1.42-2.21) times higher odds of having depressive symptoms in late adulthood, respectively. The first two trimesters of pregnancy were a critical time window during the fetal stage when severe famine had a stronger association with depressive symptoms. Famine during infant, toddler, preschool or teenage stages was not associated with depressive symptoms. Overall, famine contributed to 13.6% of the depressive symptom burden in this population. CONCLUSIONS: The Chinese Great Famine contributed substantially to the burden of depressive symptoms in China.Declaration of interestNone.
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Keywords:
Chinese Great Famine; depressive symptoms; middle-aged and older Chinese adult; national survey
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