Childhood sexual abuse and the development of recurrent major depression in Chinese women.
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Chen Jing, Cai Yiyun, Cong Enzhao, Liu Ying, Gao Jingfang, Li Youhui, Tao Ming, Zhang Kerang, Wang Xumei, Gao Chengge, Yang Lijun, Li Kan, Shi Jianguo, Wang Gang, Liu Lanfen, Zhang Jinbei, Du Bo, Jiang Guoqing, Shen Jianhua, Zhang Zhen, Liang Wei, Sun Jing, Hu Jian, Liu Tiebang, Wang Xueyi, Miao Guodong, Meng Huaqing, Li Yi, Hu Chunmei, Li Yi, Huang Guoping, Li Gongying, Ha Baowei, Deng Hong, Mei Qiyi, Zhong Hui, Gao Shugui, Sang Hong, Zhang Yutang, Fang Xiang, Yu Fengyu, Yang Donglin, Liu Tieqiao, Chen Yunchun, Hong Xiaohong, Wu Wenyuan, Chen Guibing, Cai Min, Song Yan, Pan Jiyang, Dong Jicheng, Pan Runde, Zhang Wei, Shen Zhenming, Liu Zhengrong, Gu Danhua, Wang Xiaoping, Liu Xiaojuan, Zhang Qiwen, Li Yihan, Chen Yiping, Kendler Kenneth S, Shi Shenxun, Flint Jonathan
Аннотация
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.