Watson Christopher B, Sharpley Christopher F, Bitsika Vicki, Evans Ian, Vessey Kirstan
Brain Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
Acta Psychiatr Scand. 2025 Mar 3;151(5):572-99. doi: 10.1111/acps.13794.
Childhood maltreatment (CM) and depression are serious global issues with high prevalence and lifelong impacts on physical and mental health. CM has been proposed as a modifiable risk factor for depression that, if prevented, may contribute to a reduction in the global incidence of depressive disorders. Despite this, there is a paucity of reviews examining the strength of the association between these variables. The aim of this systematic review and meta-analysis was to evaluate the empirical evidence and determine if CM is supported as a preventable risk factor for depression.
A search was performed in July 2024 for all peer-reviewed journal articles written in English examining the relationship between CM and adult depression in the electronic databases EBSCOhost, Proquest, and Embase. Studies were included in this review if they measured maltreatment before 18 years of age as the independent variable and adult depression as the dependent variable. Studies were excluded if the outcome variable was grouped with comorbidity and if they did not report primary quantitative data. A total of 77 studies with 516,302 participants met the inclusion criteria for review.
A random-effects meta-analysis was used to generate a pooled odds ratio from 87 effect estimates and demonstrated that individuals with a history of any CM are 2.5 times more likely to experience adult depression (OR = 2.49 [95% CI: 2.25-2.76]). This increase in odds remained regardless of how the primary studies screened for depression.
These findings confirmed the strong association between the experience of CM and adult depression. High heterogeneity in the meta-analytic results also suggested that further research is required that applies consistent adjustments for comorbidities and confounding factors and examines the temporal relationship between the variables to establish causality.
儿童期虐待（CM）和抑郁症是严重的全球性问题，患病率高，对身心健康具有终身影响。CM已被提出是抑郁症的一个可改变的风险因素，如果能够预防，可能有助于降低全球抑郁症的发病率。尽管如此，很少有综述研究这些变量之间关联的强度。本系统综述和荟萃分析的目的是评估实证证据，并确定CM是否可作为抑郁症的一个可预防风险因素得到支持。
2024年7月在电子数据库EBSCOhost、Proquest和Embase中检索了所有以英文撰写的、研究CM与成人抑郁症之间关系的同行评审期刊文章。如果研究将18岁之前的虐待作为自变量，将成人抑郁症作为因变量进行测量，则纳入本综述。如果结果变量与合并症分组，或者未报告主要定量数据，则排除这些研究。共有77项研究、516,302名参与者符合纳入综述的标准。
采用随机效应荟萃分析从87个效应估计值中得出合并优势比，结果表明，有任何CM病史的个体患成人抑郁症的可能性高出2.5倍（OR = 2.49 [95% CI：2.25 - 2.76]）。无论初级研究如何筛查抑郁症，这种优势的增加都依然存在。
这些发现证实了CM经历与成人抑郁症之间的强烈关联。荟萃分析结果中的高度异质性还表明，需要进一步开展研究，对合并症和混杂因素进行一致的调整，并研究变量之间的时间关系以确定因果关系。
