Frontiers in Epidemiology (May 2023)

The interplay of family history of depression and early trauma: associations with lifetime and current depression in the German national cohort (NAKO)

  • Fabian Streit,
  • Maja P. Völker,
  • Johanna Klinger-König,
  • Lea Zillich,
  • Josef Frank,
  • Iris Reinhard,
  • Jerome C. Foo,
  • Stephanie H. Witt,
  • Lea Sirignano,
  • Heiko Becher,
  • Nadia Obi,
  • Oliver Riedel,
  • Stefanie Do,
  • Stefanie Castell,
  • Max J. Hassenstein,
  • Max J. Hassenstein,
  • André Karch,
  • Andreas Stang,
  • Börge Schmidt,
  • Tamara Schikowski,
  • Anna Stahl-Pehe,
  • Hermann Brenner,
  • Hermann Brenner,
  • Laura Perna,
  • Karin Halina Greiser,
  • Rudolf Kaaks,
  • Karin B. Michels,
  • Claus-Werner Franzke,
  • Annette Peters,
  • Annette Peters,
  • Beate Fischer,
  • Julian Konzok,
  • Rafael Mikolajczyk,
  • Rafael Mikolajczyk,
  • Amand Führer,
  • Thomas Keil,
  • Thomas Keil,
  • Thomas Keil,
  • Julia Fricke,
  • Stefan N. Willich,
  • Tobias Pischon,
  • Tobias Pischon,
  • Tobias Pischon,
  • Henry Völzke,
  • Claudia Meinke-Franze,
  • Markus Loeffler,
  • Markus Loeffler,
  • Kerstin Wirkner,
  • Klaus Berger,
  • Hans J. Grabe,
  • Marcella Rietschel

DOI
https://doi.org/10.3389/fepid.2023.1099235
Journal volume & issue
Vol. 3

Abstract

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IntroductionFamily history of depression and childhood maltreatment are established risk factors for depression. However, how these factors are interrelated and jointly influence depression risk is not well understood. The present study investigated (i) if childhood maltreatment is associated with a family history of depression (ii) if family history and childhood maltreatment are associated with increased lifetime and current depression, and whether both factors interact beyond their main effects, and (iii) if family history affects lifetime and current depression via childhood maltreatment.MethodsAnalyses were based on a subgroup of the first 100,000 participants of the German National Cohort (NAKO), with complete information (58,703 participants, mean age = 51.2 years, 53% female). Parental family history of depression was assessed via self-report, childhood maltreatment with the Childhood Trauma Screener (CTS), lifetime depression with self-reported physician's diagnosis and the Mini-International Neuropsychiatric Interview (MINI), and current depressive symptoms with the depression scale of the Patient Health Questionnaire (PHQ-9). Generalized linear models were used to test main and interaction effects. Mediation was tested using causal mediation analyses.ResultsHigher frequencies of the childhood maltreatment measures were found in subjects reporting a positive family history of depression. Family history and childhood maltreatment were independently associated with increased depression. No statistical interactions of family history and childhood maltreatment were found for the lifetime depression measures. For current depressive symptoms (PHQ-9 sum score), an interaction was found, with stronger associations of childhood maltreatment and depression in subjects with a positive family history. Childhood maltreatment was estimated to mediate 7%–12% of the effect of family history on depression, with higher mediated proportions in subjects whose parents had a depression onset below 40 years. Abuse showed stronger associations with family history and depression, and higher mediated proportions of family history effects on depression than neglect.DiscussionThe present study confirms the association of childhood maltreatment and family history with depression in a large population-based cohort. While analyses provide little evidence for the joint effects of both risk factors on depression beyond their individual effects, results are consistent with family history affecting depression via childhood maltreatment to a small extent.

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