Objective

Early life stress (ELS) is associated with increased risk for the development of major depressive disorder (MDD) in adulthood; however, the degree to which ELS is associated with an early onset of MDD (ie, during childhood or adolescence) is not known. In this meta-analysis, we estimated the associations between ELS and the risk for onset of MDD before age 18 years. In addition, we examined the associations between eight specific forms of ELS (ie, sexual abuse, physical abuse, poverty, physical illness/injury, death of a family member, domestic violence, natural disaster, and emotional abuse) and risk for youth-onset MDD.

Method

We conducted a systematic search in scientific databases for studies that assessed both ELS and the presence or absence of MDD before age 18 years. We identified 62 journal articles with a total of 44,066 unique participants. We assessed study quality using the Newcastle−Ottawa Scale. When heterogeneous effect sizes were detected, we tested whether demographic and/or methodological factors moderated the association between ELS and MDD.

Results

Using a random-effects meta-analysis, we found that individuals who experienced ELS were more likely to develop MDD before the age of 18 years than were individuals without a history of ELS (odds ratio = 2.50; 95% confidence interval 2.08, 3.00). Separate meta-analyses revealed a range of associations with MDD: whereas some types of ELS (eg, poverty) were not associated with MDD, other types (eg, emotional abuse) were associated more strongly with MDD than was ELS considered more broadly.

Conclusion

These findings provide important evidence that the adverse effect of ELS on MDD risk manifests early in development, prior to adulthood, and varies by type of ELS.

中文翻译：

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荟萃分析：暴露于早期生活压力和儿童和青春期抑郁症的风险。

客观的

早期生活压力 (ELS) 与成年期患重度抑郁症 (MDD) 的风险增加有关；然而，ELS 与 MDD 早发（即儿童期或青春期）的相关程度尚不清楚。在这项荟萃分析中，我们估计了 ELS 与 18 岁之前 MDD 发病风险之间的关联。此外，我们研究了八种特定形式的 ELS（即性虐待、身体虐待、贫困、身体疾病/伤害、家庭成员死亡、家庭暴力、自然灾害和情感虐待）与青少年风险之间的关联——发病MDD。

方法

我们在科学数据库中进行了系统搜索，以寻找在 18 岁之前评估 ELS 和 MDD 存在与否的研究。我们确定了 62 篇期刊文章，共有 44,066 名独立参与者。我们使用纽卡斯尔-渥太华量表评估研究质量。当检测到异质效应大小时，我们测试了人口统计学和/或方法学因素是否会调节 ELS 和 MDD 之间的关联。

结果

使用随机效应荟萃分析，我们发现经历过 ELS 的个体比没有 ELS 病史的个体更有可能在 18 岁之前患上 MDD（优势比 = 2.50；95% 置信区间 2.08、3.00） . 单独的荟萃分析揭示了与 MDD 的一系列关联：虽然某些类型的 ELS（例如，贫困）与 MDD 无关，但其他类型（例如，情感虐待）与 MDD 的相关性比 ELS 更广泛地考虑的更强烈。

结论

这些发现提供了重要的证据，表明 ELS 对 MDD 风险的不利影响在发育早期、成年之前就表现出来了，并且因 ELS 的类型而异。