Early-life exposure to severe famine and subsequent risk of depressive symptoms in late adulthood: the China Health and Retirement Longitudinal Study. (3rd July 2018)

• Record Type: Journal Article
• Authors: Li, Changwei; Miles, Toni; Shen, Luqi; Shen, Ye; Liu, Tingting; Zhang, Mengxi; Li, Shengxu; Huang, Cheng
• Is Part Of: British journal of psychiatry. Volume 213:Number 4(2018)
• Page Start: 579
• Page End: 586
• Publication Date: 2018-07-03
• Subjects: Chinese Great Famine, -- depressive symptoms, -- middle-aged and older Chinese adult, -- national survey; Psychiatry -- Periodicals; Psychology, Pathological -- Periodicals; 616.89005
• DOI: 10.1192/bjp.2018.116
• Languages: English
• ISSNs: 0007-1250

Abstract

Abstract : Background: The Chinese Great Famine caused widespread starvation in 1959–1961. Its long-term association with depressive symptoms has not been studied. Aims: To estimate the burden of depressive symptoms and the association of famine exposure with depressive symptoms. Method: The China Health and Retirement Longitudinal Study is a nationwide representative survey of 17 708 Chinese adults aged ≥45. Propensity score matching and modified Poisson regression were used to evaluate the association between self-reported famine exposure in early life and depressive symptoms among the overall participants. Such associations were also assessed by developmental stage using modified Poisson regression and logistic regression. Results: The prevalence of depressive symptoms was 26.2% (95% CI 25.1–27.3%) in 2011. As defined by loss of family members because of starvation, 11.6% (95% CI 10.1–13.1%) of this population experienced severe famine. When compared with participants who did not experience starvation, those who had experienced severe famine during fetal, mid-childhood, young-teenage and early-adulthood stages had 1.87 (95% CI 1.36–2.55), 1.54 (95% CI 1.23–1.94), 1.47 (95% CI 1.09–2.00) and 1.77 (95% CI 1.42–2.21) times higher odds of having depressive symptoms in late adulthood, respectively. The first two trimesters of pregnancy were a critical time window during the fetal stage when severe famine had a stronger association with depressive symptoms. Famine during infant, toddler, preschool or teenage stages was not associated with depressive symptoms. Overall, famine contributed to 13.6% of the depressive symptom burden in this population. Conclusions: The Chinese Great Famine contributed substantially to the burden of depressive symptoms in China. Declaration of interest: None.