PLoS ONE (Jan 2014)

Childhood sexual abuse and the development of recurrent major depression in Chinese women.

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

DOI
https://doi.org/10.1371/journal.pone.0087569
Journal volume & issue
Vol. 9, no. 1
p. e87569

Abstract

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BackgroundOur 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?MethodThree 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.ResultsWe 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.ConclusionsIn 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.