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

Jing Chen(Huashan Hospital), Yiyun Cai(Fudan University), Enzhao Cong(Shanghai Mental Health Center), Ying Liu(First Hospital of China Medical University), Jingfang Gao(Hangzhou Hospital of Traditional Chinese Medicine), Youhui Li(Centre for Human Genetics), Ming Tao, Kerang Zhang(Shanxi Medical University), Xumei Wang(China Medical University), Chengge Gao(Xi'an Jiaotong University), Lijun Yang(Brain Hospital of Jilin), Kan Li(Jiangxi Mental Health Center), Jianguo Shi(Xian Mental Health Center), Gang Wang(Beijing Anding Hospital), Lanfen Liu(Shandong Mental Health Center), Jinbei Zhang(Sun Yat-sen University), Bo Du(Hebei Mental Health Center), Guoqing Jiang(Chongqing City Mental Health Center), Jianhua Shen(Tianjin People's Hospital), Zhen Zhang(Affiliated Hospital of Jiangsu University), Wei Liang(Henan Psychiatric Hospital), Jing Sun(Nanjing Brain Hospital), Jian Hu(Harbin Medical University), Tiebang Liu(ShenZhen People’s Hospital), Xueyi Wang(Renmin Hospital of Wuhan University), Guodong Miao(Guangzhou Psychiatric Hospital), Huaqing Meng(Chongqing Medical University), Yi Li(Centre for Human Genetics), Chunmei Hu, Yi Li(Zhengzhou University), Guoping Huang(Sichuan Mianyang 404 Hospital), Gongying Li(Jining Medical University), Baowei Ha(Liaocheng People's Hospital), Hong Deng(West China Hospital of Sichuan University), Qiyi Mei(Suzhou Guangji Hospital), Hui Zhong(Anhui Mental Health Center), Shugui Gao(Ningbo Kangning Hospital), Hong Sang(Sixth Hospital of Changchun City), Yutang Zhang(Lanzhou University Second Hospital), Xiang Fang(Fuzhou Neuro Psychiatric Hospital), Fengyu Yu(Heilongjiang Provincial Hospital), Donglin Yang, Tieqiao Liu(ShenZhen People’s Hospital), Yunchun Chen(MRC Clinical Trials Unit at UCL), Xiaohong Hong(Shantou University Mental Health Center), Wenyuan Wu(Tongji University), Guibing Chen(Huaian First People’s Hospital), Min Cai(Third People's Hospital of Huzhou), Yan Song(Mudanjiang Medical University), Jiyang Pan(Jinan University), Jicheng Dong(Qingdao Mental Health Center), Runde Pan(Guangxi Zhuang Autonomous Region Brain Hospital), Wei Zhang(Daqing City People's Hospital), Zhenming Shen(Tangshan People's Hospital), Zhengrong Liu(Anshan Hospital), Danhua Gu(Weihai City Mental Health Center), Xiaoping Wang(First Affiliated Hospital of Hebei Medical University), Xiaojuan Liu(Tianjin Medical University), Qiwen Zhang(Tianjin Anding Hospital), Yihan Li(Zhengzhou University), Yiping Chen(MRC Clinical Trials Unit at UCL), Kenneth S. Kendler(Virginia Commonwealth University), Shenxun Shi(Fudan University), Jonathan Flint(Centre for Human Genetics)
PLoS ONE
January 29, 2014
10.1371/journal.pone.0087569
Cited by 49Open Access
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Abstract

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.

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