Separate and joint associations of adverse childhood experiences and childhood socioeconomic status with depressive symptoms: The mediating role of unhealthy lifestyle factors.

IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Journal of affective disorders Pub Date : 2025-01-15 Epub Date: 2024-10-29 DOI:10.1016/j.jad.2024.10.117
Yifang Liu, Zhikang Wang, Ziyi Cheng, Yilin Li, Qi Wang, Junan Liu
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Abstract

Background: The associations between adverse childhood experiences (ACEs), childhood socioeconomic status (SES), and depressive symptoms (DS) remain unclear. This study aimed to assess the separate and joint associations of ACEs and childhood SES with DS and explore the potential mediating role of lifestyles.

Methods: Data were obtained from the China Health and Retirement Longitudinal Study, which included 6879 participants. Cox proportional hazard models were used to evaluate the associations of ACEs and childhood SES with DS. Additive and multiplicative interactions between ACEs and childhood SES on DS were also examined. Causal mediation analyses were then conducted to quantify the mediating role of lifestyle factors in these associations.

Results: During a median follow-up of 3.0 years, 1283 (18.7 %) participants were identified with DS. ACEs and low childhood SES were significantly associated with an increased risk of DS (ACEs [3 or more vs 0]: HR = 1.68, 95 % CI: 1.43-1.99; childhood SES [low vs high]: HR = 1.48, 95 % CI: 1.22-1.79). Compared to the no ACEs-moderate/high childhood SES group, the group with 1 or more ACEs-low childhood SES had the highest risk of DS (HR = 1.76, 95 % CI: 1.47-2.10). Significant additive interaction of ACEs with low childhood SES on DS was observed with relative excess risk due to an interaction of 1.21 (95 % CI: 0.27, 2.15). Sleep duration and smoking were identified as the potentially modifiable mediators.

Conclusions: The findings highlight the importance of promoting initiatives to address ACEs, low childhood SES, and unhealthy lifestyles as part of DS prevention strategies.

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童年不良经历和童年社会经济地位与抑郁症状的单独和联合关联:不健康生活方式因素的中介作用。
背景:童年不良经历(ACE)、童年社会经济地位(SES)和抑郁症状(DS)之间的关系仍不清楚。本研究旨在评估ACE和童年社会经济地位与抑郁症状之间的单独和联合关联,并探讨生活方式的潜在中介作用:方法:数据来自中国健康与退休纵向研究(China Health and Retirement Longitudinal Study),其中包括 6879 名参与者。方法:数据来源于中国健康与退休纵向研究(China Health and Retirement Longitudinal Study),该研究共纳入了 6879 名参与者。同时还研究了ACE和童年SES对DS的加乘交互作用。然后进行了因果中介分析,以量化生活方式因素在这些关联中的中介作用:在 3.0 年的中位随访期间,有 1283 人(18.7%)被确认患有 DS。ACE和低童年社会经济地位与 DS 风险的增加有显著相关性(ACE [3 或更多 vs 0],HR = 1.68,95 %):HR=1.68,95% CI:1.43-1.99;童年社会经济地位[低 vs 高]:HR = 1.48,95 % CI:1.22-1.79)。与无 ACEs-中/高童年社会经济地位组相比,有 1 个或 1 个以上 ACEs-低童年社会经济地位组患 DS 的风险最高(HR = 1.76,95 % CI:1.47-2.10)。观察发现,ACE 与低童年 SES 对 DS 有显著的叠加交互作用,交互作用导致的相对超额风险为 1.21(95 % CI:0.27,2.15)。睡眠时间和吸烟被认为是潜在的可调节因素:研究结果突出表明,作为 DS 预防策略的一部分,推动解决 ACE、儿童社会经济地位低下和不健康生活方式问题的措施非常重要。
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来源期刊
Journal of affective disorders
Journal of affective disorders 医学-精神病学
CiteScore
10.90
自引率
6.10%
发文量
1319
审稿时长
9.3 weeks
期刊介绍: The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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