Department of Global Health Promotion, Tokyo Medical and Dental University, Yushima-ku, Tokyo 113-8510, Japan.
Int J Environ Res Public Health. 2020 Mar 27;17(7):2257. doi: 10.3390/ijerph17072257.
Adverse childhood experiences (ACEs) are assumed to increase the risk of depression in late life via development of poor mental health conditions; however, the association between mental distress in childhood and geriatric depression has not been directly examined. This study examined the association between childhood suicidal ideation and geriatric depression, using population-based, cross-sectional survey data from 1140 community-dwelling, functionally independent older adults in Wakuya City, Japan. We assessed childhood suicidal ideation by asking the participants whether they had seriously considered attempting suicide before the age of 18, together with geriatric depression, using the Japanese version of the 15-item Geriatric Depression Scale. Poisson regression was applied to adjust for potential confounders and mediators. In total, 6.1% of the participants reported childhood suicidal ideation. After adjustment for sex, age, personality attributes and ACEs, childhood suicidal ideation was positively associated with geriatric depression prevalence ratio [PR]: 1.40, 95% Confidence Interval (95%CI): 1.04-1.88). The increased PR of geriatric depression remained significant, even after further adjustment for adulthood socio-economic status, recent life stressors and current health status (PR: 1.38, 95%CI: 1.02-1.88). Further prospective studies are warranted, but efforts to deliver mental health services to children with suicidal ideation potentially diminish the highly prevalent geriatric depression.
不良的童年经历（ACEs）被认为会通过不良心理健康状况的发展增加晚年患抑郁症的风险；然而，儿童期精神困扰与老年抑郁症之间的关联尚未得到直接检验。本研究使用日本若叶市 1140 名社区居住、功能独立的老年人的基于人群的横断面调查数据，检验了儿童期自杀意念与老年抑郁症之间的关联。我们通过询问参与者是否在 18 岁之前曾认真考虑过自杀来评估儿童期自杀意念，同时使用日本版的 15 项老年抑郁量表评估老年抑郁症。应用泊松回归来调整潜在的混杂因素和中介因素。共有 6.1%的参与者报告了儿童期自杀意念。在校正性别、年龄、人格特质和 ACEs 后，儿童期自杀意念与老年抑郁症的患病率比（PR）呈正相关[PR：1.40，95%置信区间（95%CI）：1.04-1.88]。即使进一步调整了成年期社会经济地位、近期生活压力源和当前健康状况，老年抑郁症的 PR 仍然显著增加（PR：1.38，95%CI：1.02-1.88）。需要进一步的前瞻性研究，但为有自杀意念的儿童提供心理健康服务的努力可能会降低普遍存在的老年抑郁症的患病率。
