Association between childhood maltreatment with subthreshold depressive symptoms and major depressive disorder in young and middle-aged adults
Jing-Man Shi, Yu-Hua Liao, Yan-Zhi Li, Gia Han Le, Roger S McIntyre, Wei-Hong Zhang, Ines Keygnaert, Wan-Xin Wang, Lan Guo, Hui-Min Zhang, Cai-Hong Gao, Yan Chen, Xue Han, Ci-Yong Lu
Jing-Man Shi, Yan-Zhi Li, Wan-Xin Wang, Lan Guo, Ci-Yong Lu, Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Jing-Man Shi, Wei-Hong Zhang, Ines Keygnaert, International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent 9000, Belgium
Yu-Hua Liao, Hui-Min Zhang, Cai-Hong Gao, Yan Chen, Xue Han, Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, Guangdong Province, China
Gia Han Le, Institute of Medical Science, University of Toronto, Toronto M5S 3H2, Canada
Gia Han Le, Roger S McIntyre, Department of Pharmacology and Toxicology, University of Toronto, Toronto M5S 3H2, Canada
Roger S McIntyre, Department of Psychiatry, University of Toronto, Toronto M5S 1A1, Canada
Wei-Hong Zhang, School of Public Health, Université libre de Bruxelles (ULB), Bruxelles 1050, Belgium
Co-first authors: Jing-Man Shi and Yu-Hua Liao.
Co-corresponding authors: Xue Han and Ci-Yong Lu.
Author contributions: Shi JM conceptualized the study, visualized the data, curated the data, performed formal analysis, and wrote the original draft; Liao YH and Li YZ conceptualized the study, curated the data, performed formal analysis, and developed the methodology; Wang WX, Guo L, Zhang HM, Chen Y, and Gao CH managed the project and performed the investigation; Le GH, McIntyre RS, Zhang WH, and Keygnaert I developed the methodology and reviewed and edited the manuscript; Han X and Lu CY conceptualized the study, acquired funding, performed the investigation, developed the methodology, managed the project, provided resources, visualized the data, and supervised the study. Shi JM and Liao YH contributed equally to this work as co-first authors. This study was jointly led by Professor Lu CY of Sun Yat-sen University and Han X from Shenzhen Nanshan Center for Chronic Disease Control. The two corresponding authors contributed complementary expertise that was both essential and non-overlapping in the execution of this project. Professor Lu CY was responsible for the overall study conceptualization, methodological design, and academic supervision. He played a central role in shaping the theoretical framework and ensuring the scientific rigor of the research. Han X, on the other hand, led the fieldwork and project implementation on the ground. She coordinated participant recruitment, managed on-site data collection, and maintained collaboration with local primary care institutions. Her leadership was critical to ensuring data quality and successful execution within community-based settings. Given the nature of this collaborative structure-combining academic leadership with field-based operational oversight-we believe that co-corresponding authorship accurately reflects the dual-core contributions of both individuals.
Supported by National Natural Science Foundation of China, No. 82373660 and No. 81761128030; Sanming Project of Medicine in Shenzhen Nanshan, No. 11; and the China Scholarship Council.
Institutional review board statement: This study was approved by the Institutional Review Board and Ethics Committee of Sun Yat-sen University School of Public Health (Ethical code: L2017044) and adhered to the principles of the Declaration of Helsinki.
Informed consent statement: Informed consent was obtained from all participants.
Conflict-of-interest statement: Dr. Roger S. McIntyre has received research grant support from CIHR/GACD/National Natural Science Foundation of China (NSFC) and the Milken Institute; speaker/consultation fees from Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Neurawell, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris, Sanofi, Eisai, Intra-Cellular, NewBridge Pharmaceuticals, Viatris, Abbvie, Atai Life Sciences. Dr. Roger S. McIntyre is a CEO of Braxia Scientific Corp.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets used and/or analyzed in the present study can be obtained from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Ci-Yong Lu, MD, PhD, Department of Medical Statistics and Epi
demiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, Guangdong Province, China.
luciyong@mail.sysu.edu.cn
Received: June 18, 2025
Revised: August 2, 2025
Accepted: September 1, 2025
Published online: November 19, 2025
Processing time: 139 Days and 18 Hours
