Violence across the lifespan and its association with depression: cumulative effects and psychosocial moderation in the UK Biobank.

PURPOSE: Violence exposure is a well-established risk factor for depression, yet few large-scale studies have examined how distinct violence types across the lifespan interact to shape depression trajectories or how psychosocial factors may moderate these effects.

METHODS

Drawing on data from 35,921 UK Biobank participants, we examined cross-sectional and prospective associations of childhood maltreatment, lifetime violence, and intimate partner violence (IPV) with depressive symptom severity and depression diagnosis (case-control design with propensity score matching). Hierarchical regression models tested main effects adjusting for confounders (age, sex, socioeconomic status [SES]), and interaction terms tested moderation by SES, social support, and loneliness.

RESULTS

All violence exposures were independently associated with greater depression severity and higher odds of depression diagnosis. Cumulative exposure demonstrated additive, synergistic, and nonlinear effects, with co-occurring violence types compounding psychological risk. Loneliness amplified violence-depression associations, while social support buffered these relationships. SES did not moderate violence effects. Prospective analyses confirmed that violence exposure predicted future depressive symptoms beyond baseline severity. In case-control analyses of clinical depression, IPV contributed the highest population attributable fraction (1.8%), followed by lifetime violence (1.1%) and childhood maltreatment (0.6%).

CONCLUSIONS

Depression risk following violence is shaped not only by violence exposure per se, but also by modifiable psychosocial factors, with loneliness and social support emerging as critical intervention targets. These findings highlight the need for integrated violence screening and targeted psychosocial interventions within mental health and public health strategies.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1007/s00127-026-03079-3.