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Monday, April 20, 2015

Childhood Adversity and Major Depression

A very consistent result in the epidemiological literature is the association between childhood adversity and the subsequent occurrence of major depression during adulthood. More recently, this concept has been expanded with studies reporting associations between childhood adversity and a large number of different adult health outcomes (e.g. cardiovascular disease). A weakness in this literature is that most of the studies arise from retrospective assessment of childhood adversities - which is problematic since peoples' perceptions of their childhoods could easily be influenced by their adult health status. We recently sought to get around this problem by linking a childhood survey to data collected later, during adulthood. There were two outcomes that stood out as being strongly related to childhood adversity: depression and smoking. These are, of course, related outcomes since smoking is strongly related to depression in adolescents, who may smoke to self-medicate and depressed adolescents may also be at much higher risk of becoming nicotine dependent. These findings, summarized here, suggest that depression may be the "lynch pin" linking childhood adversities to later health problems through intermediate mechanisms such as smoking. This may provide an opportunity (management of depression) to prevent many of the later-life health problems that seem to be associated with adverse childhood events.

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