关键词: 儿童期虐待, 亚类型, 抑郁, 元分析

Abstract:

Childhood maltreatment is closely correlated with depression but only a few studies have examined the specific effects of various types of childhood abuse on depression. Moreover, the comparability of previous research is seriously limited because a high level of heterogeneity can be observed across the published studies. This meta-analysis was to estimate the association between depression and different types of childhood maltreatment (psychological abuse and neglect, sexual abuse, physical abuse and neglect). A systematic review was conducted to study the relationship between subtype of childhood maltreatment and depression. A total of 92 independent effect sizes (31 studies, 24283 participants) were found within the criteria of the meta-analysis. After coding the data, independent effect sizes were analyzed by CMA 3.0 program. Odd ratios and 95 % CI of effect sizes were calculated by using random-effects model. Four items including heterogeneity test, publication bias test, main effects analysis and moderation effect were analyzed. There was a significant heterogeneity in 92 independent effect sizes in heterogeneity, and the random-effects model was an appropriate model for subsequent meta-analyses. The impact of publication bias was modest and the major finding still remained valid. The research revealed a robust association between childhood maltreatment and depression (OR = 2.84, 95% CI: 2.45 – 3.29). In addition, the meta-analyses for each type of maltreatment revealed that psychological abuse (OR = 3.58, 95%CI 2.87 – 4.48) and emotional neglect (OR = 3.24, 95%CI 2.43 – 4.32) were most strongly associated with the outcome of depression. The analysis revealed that the participant’s age and sex could affect the relationship between childhood maltreatment and depression. This meta-analysis addressed the different effects of sub-types for childhood maltreatment on depression. The findings implied that childhood maltreatment was a genuine risk factor for depression, especially highlighting the potential impact of the more “silent” types of childhood maltreatment on the development of depression. Moreover, our findings raise our awareness for the potential needs of adolescents or women who were formerly exposed to childhood abuse. This is important to prevent their depression and is thus a general public health issue. Clinicians also have to be aware of the importance of early childhood experiences to better meet the needs of their patients.

Key words: childhood maltreatment, subtypes, depression, meta-analysis