Association between childhood maltreatment with subthreshold depressive symptoms and major depressive disorder in young and middle-aged adults

Table 1 Characteristics of the study participants, n (%)

	Overall (n = 3209)	Non-depressed (n = 143)	SDS (n = 1524)	MDD (n = 1542)	P value1
Demographic characteristics
Age (years)2	33.6 ± 10.2	37.2 ± 10.4	38.5 ± 10.1	28.4 ± 7.4	< 0.001
Age group					< 0.001
18-44 years	2680 (83.5)	110 (76.9)	1096 (71.9)	1474 (95.6)
45-59 years	529 (16.5)	33 (23.1)	428 (28.1)	68 (4.4)
Gender					< 0.001
Male	1089 (34.0)	34 (23.8)	583 (38.3)	472 (30.6)
Female	2118 (66.0)	109 (76.2)	939 (61.7)	1070 (69.4)
Missing data	2	0	2	0
Marital status					< 0.001
Single	1498 (47.1)	49 (34.3)	449 (29.5)	1000 (66.0)
Married	1541 (48.5)	89 (62.2)	1017 (66.9)	435 (28.7)
Divorce/widowed	139 (4.4)	5 (3.5)	54 (3.6)	80 (5.3)
Missing data	31	0	4	27
Education					< 0.001
Below undergraduate	1574 (49.2)	72 (50.3)	826 (54.5)	676 (43.9)
Undergraduate or above	1624 (50.8)	71 (49.7)	691 (45.5)	862 (56.1)
Missing data	11	0	7	4
Employed status					0.050
Employed	2667 (83.4)	114 (79.7)	1290 (85.0)	1263 (82.2)
Un-employed	530 (16.6)	29 (20.3)	227 (15.0)	274 (17.8)
Missing data	12	0	7	5
Family income					< 0.001
< 20000¥	2205 (71.1)	119 (83.2)	1134 (74.7)	952 (66.0)
≥ 20000¥	898 (28.9)	24 (16.8)	383 (25.3)	491 (34.0)
Missing data	106	0	7	99
Health status and behavioral habits
Chronic disease					< 0.001
No	899 (28.1)	27 (18.9)	381 (25.0)	491 (32.1)
Yes	2299 (71.9)	116 (81.1)	1143 (75.0)	1040 (67.9)
Missing data	11	0	0	11
Smoking					< 0.001
No	1099 (34.4)	27 (18.9)	418 (27.5)	654 (42.6)
Yes	2100 (65.6)	116 (81.1)	1104 (72.5)	880 (57.4)
Missing data	10	0	2	8
Drinking					< 0.001
No	2374 (74.1)	84 (58.7)	975 (64.1)	1315 (85.5)
Yes	829 (25.9)	59 (41.3)	547 (35.9)	223 (14.5)
Missing data	6	0	2	4
Exercise habit per week (at least 1 time and ≥ 30 minutes)					< 0.001
No	2060 (64.5)	84 (59.2)	867 (57.0)	1109 (72.3)
Yes	1135 (35.5)	58 (40.8)	653 (43.0)	424 (27.7)
Missing data	14	1	4	9
PHQ-9	13.1 ± 7.3	1.6 ± 1.4	8.7 ± 4.5	18.4 ± 5.5	< 0.001

¹T-tests were used for continuous variables.

²Data are presented as the mean ± SD.

χ² tests were used for categorical variables. SDS: Subthreshold depressive symptoms; MDD: Major depressive disorder; PHQ-9: Patient Health Quetionaire-9.

Table 2 The average scores of different types of childhood maltreatment in young and middle-aged adults by subthreshold depressive symptoms and major depressive disorder groups

Variables	Young adults (18-44 years old) (n = 2680)	Middle-aged adults (45-59 years old) (n = 529)	P value
CTQ-SF total score	44.7 ± 14.0	39.1 ± 11.4	< 0.001
Non-depressed	36.1 ± 9.8	35.5 ± 8.6	0.769
SDS	41.7 ± 13.4	39.0 ± 11.5	< 0.05
MDD	47.6 ± 14.1	41.2 ± 11.7	< 0.05
CTQ-SF scores for physical abuse	6.5 ± 2.9	5.8 ± 2.0	< 0.001
Non-depressed	5.3 ± 0.9	5.4 ± 1.2	0.486
SDS	6.1 ± 2.6	5.8 ± 2.0	< 0.05
MDD	6.9 ± 3.2	6.0 ± 2.3	< 0.05
CTQ-SF scores for emotional abuse	8.7 ± 4.4	6.5 ± 2.5	< 0.001
Non-depressed	6.1 ± 1.9	5.7 ± 1.4	0.252
SDS	7.4 ± 3.5	6.5 ± 2.4	< 0.001
MDD	9.9 ± 4.7	7.3 ± 3.1	< 0.001
CTQ-SF scores for sexual abuse	5.7 ± 1.9	5.5 ± 1.6	< 0.05
Non-depressed	5.3 ± 1.0	5.2 ± 0.9	0.821
SDS	5.7 ± 2.0	5.5 ± 1.7	0.071
MDD	5.7 ± 1.8	5.6 ± 1.2	0.507
CTQ-SF scores for physical neglect	9.6 ± 3.8	9.5 ± 3.4	0.394
Non-depressed	8.1 ± 3.1	9.0 ± 3.0	0.181
SDS	9.5 ± 3.7	9.5 ± 3.4	0.845
MDD	9,8 ± 3.8	9.5 ± 3.5	0.561
CTQ-SF scores for emotional neglect	14.2 ± 5.9	11.8 ± 5.5	< 0.001
Non-depressed	11.3 ± 6.3	10.2 ± 4.9	0.375
SDS	12.9 ± 6.1	11.7 ± 5.6	< 0.05
MDD	15.3 ± 5.4	12.8 ± 5.4	< 0.05

SDS: Subthreshold depressive symptoms; MDD: Major depressive disorder; CTQ-SF: Childhood Trauma Questionnaire-28 item Short Form.

Table 3 Univariate and multivariate analysis of association between different types of childhood maltreatment and subthreshold depressive symptoms or major depressive disorder

Variables	SDS		MDD		SDS		MDD
	OR (95%CI)1	P value	OR (95%CI)1	P value	AOR (95%CI)2	P value	AOR (95%CI)2	P value
CTQ-SF	1.04 (1.03, 1.06)	< 0.001	1.08 (1.06, 1.10)	< 0.001	1.05 (1.03, 1.07)	< 0.001	1.07 (1.05, 1.09)	< 0.001
Physical abuse	1.49 (1.22, 1.82)	< 0.001	1.66 (1.36, 2.03)	< 0.001	1.41 (1.16, 1.71)	< 0.05	1.48 (1.22, 1.79)	0.001
Emotional abuse	1.24 (1.13, 1.36)	< 0.001	1.47 (1.33, 1.62)	< 0.001	1.28 (1.13, 1.44)	< 0.001	1.41 (1.24, 1.59)	< 0.001
Sexual abuse	1.28 (1.05, 1.56)	< 0.05	1.30 (1.07, 1.58)	< 0.05	1.26 (1.05, 1.52)	< 0.05	1.22 (1.01, 1.48)	< 0.05
Physical neglect	1.11 (1.05, 1.17)	< 0.001	1.13 (1.07, 1.19)	< 0.001	1.11 (1.05, 1.18)	< 0.001	1.13 (1.06, 1.19)	< 0.001
Emotional neglect	1.05 (1.02, 1.09)	< 0.05	1.14 (1.10, 1.17)	< 0.001	1.06 (1.02, 1.09)	< 0.05	1.11 (1.08, 1.15)	< 0.001

¹Univariate model.

²Adjusted for sex, age, marital status, education, employed status, family income, chronic disease, smoking, drinking, exercise habit per week.

SDS: Subthreshold depressive symptoms; MDD: Major depressive disorder; CTQ-SF: Childhood Trauma Questionnaire-28 item Short Form.

Table 4 Association between different types of childhood maltreatment with subthreshold depressive symptoms in young and middle-aged adults

Variables	Young adults (18-44 years old) (n = 2680)				Middle-aged adults (45-59 years old) (n = 529)
	OR (95%CI)1	P value	AOR (95%CI)2	P value	OR (95%CI)1	P value	AOR (95%CI)2	P value
CTQ-SF	1.04 (1.03, 1.07)	< 0.001	1.05 (1.03, 1.07)	< 0.001	1.03 (0.99, 1.07)	0.089	1.04 (0.99, 1.08)	0.055
Physical abuse	1.64 (1.27, 2.11)	< 0.001	1.57 (1.22, 2.02)	< 0.001	1.17 (0.88, 1.54)	0.282	1.12 (0.86, 1.47)	0.396
Emotional abuse	1.25 (1.12, 1.39)	< 0.001	1.25 (1.12, 1.39)	< 0.001	1.24 (0.97, 1.59)	0.083	1.26 (0.98, 1.62)	0.073
Sexual abuse	1.30 (1.04, 1.62)	< 0.05	1.28 (1.03, 1.59)	< 0.05	1.21 (0.82, 1.79)	0.336	1.18 (0.81, 1.71)	0.383
Physical neglect	1.13 (1.06, 1.20)	< 0.001	1.12 (1.05, 1.20)	< 0.001	1.05 (0.94, 1.17)	0.379	1.07 (0.96, 1.21)	0.216
Emotional neglect	1.05 (1.02, 1.09)	< 0.05	1.05 (1.01, 1.09)	< 0.05	1.06 (0.98, 1.14)	0.132	1.07 (0.99, 1.15)	0.075

¹Univariate model.

²Adjusted for sex, marital status, education, employed status, family income, chronic disease, smoking, drinking, exercise habit per week.

CTQ-SF: Childhood Trauma Questionnaire-28 item Short Form.

Table 5 Association between different types of childhood maltreatment with major depressive disorder in young and middle-aged adults

Variables	Young adults (18-44 years old) (n = 2680)				Middle-aged adults (45-59 years old) (n = 529)
	OR (95%CI)1	P value	AOR (95%CI)2	P value	OR (95%CI)1	P value	AOR (95%CI)2	P value
CTQ-SF	1.08 (1.06, 1.11)	< 0.001	1.08 (1.05, 1.10)	< 0.001	1.05 (1.01, 1.09)	< 0.05	1.05 (1.01, 1.10)	< 0.05
Physical abuse	1.80 (1.40, 2.33)	< 0.001	1.68 (1.31, 2.16)	< 0.001	1.22 (0.91, 1.64)	0.181	1.17 (0.88, 1.57)	0.280
Emotional abuse	1.45 (1.31, 1.61)	< 0.001	1.41 (1.27, 1.56)	< 0.001	1.38 (1.07, 1.78)	< 0.05	1.33 (1.02, 1.73)	< 0.05
Sexual abuse	1.30 (1.05, 1.63)	< 0.05	1.25 (1.01, 1.55)	< 0.05	1.24 (0.82, 1.87)	0.306	1.18 (0.79, 1.77)	0.426
Physical neglect	1.15 (1.08, 1.22)	< 0.001	1.15 (1.08, 1.22)	< 0.001	1.05 (0.93, 1.19)	0.442	1.07 (0.93, 1.22)	0.348
Emotional neglect	1.13 (1.09, 1.18)	< 0.001	1.12 (1.08, 1.17)	< 0.001	1.09 (1.01, 1.19)	< 0.05	1.09 (1.01, 1.19)	< 0.05

¹Univariate model.

²Adjusted for sex, marital status, education, employed status, family income, chronic disease, smoking, drinking, exercise habit per week.

CTQ-SF: Childhood Trauma Questionnaire-28 item Short Form.