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| Item Type: | Preprint |
|---|---|
| Title: | Examining the contribution of childhood maltreatment to the gender gap in depression: insights from the German National Cohort (NAKO) |
| Creators Name: | Völker, Maja P., Kresken, Aina L., Foo, Jerome C., Frank, Josef, Reinhard, Iris, Klinger-König, Johanna, Zillich, Lea, de Sá, Diana S. Ferreira, Mikolajczyk, Rafael, Leitzmann, Michael, Bohmann, Patricia, Krist, Lilian, Keil, Thomas, Meinke-Franze, Claudia, Riedel-Heller, Steffi, Greiser, Halina, Bohn, Barbara, Brenner, Hermann, Obi, Nadia, Harth, Volker, Pischon, Tobias, Grabe, Hans J., Berger, Klaus, Schwarz, Emanuel, Mata, Jutta, Witt, Stephanie H. and Streit, Fabian |
| Abstract: | BACKGROUND: Childhood maltreatment is a major risk factor for depression and may contribute to sex differences in depression prevalence. We examined sex-specific associations between childhood maltreatment and depression and estimated the proportion of depression cases attributable to specific maltreatment subtypes. METHODS: We analyzed baseline data from 159,045 participants (49.4% women; aged 19–72) in the German National Cohort (NAKO). Childhood maltreatment was assessed via the Childhood Trauma Screener; depression via self-reported physician’s diagnosis and MINI classification (lifetime) and the PHQ-9 (current). Associations, including sex interactions, were modeled using binary logistic regressions. Mediation analyses and sex-stratified population attributable fractions (PAFs) quantified the contribution of maltreatment to depression. RESULTS: Maltreatment was associated with increased odds of lifetime (OR(physician’s diagnosis)=2.45 [2.38,2.53]; OR(MINI)=2.30 [2.18,2.43]) and current depression (OR=2.90 [2.79,3.02]). Sex interactions were observed for the physician’s diagnosis: physical abuse and neglect had stronger associations in women (OR(physical abuse)=2.74 [2.59,2.90]; OR(physical neglect)=1.36 [1.28,1.44]) than men (OR(physical abuse)=2.36 [2.21,2.52]; OR(physical neglect)=1.08 [1.00,1.16]), whereas sexual abuse showed stronger associations in men (OR=3.23 [2.91,3.57]) than women (OR=2.61 [2.48,2.75]). Overall, childhood maltreatment accounted for 21.2-26.2% of lifetime and 33.4% of current depression. PAFs were higher in women than men for lifetime (24.5-28.5% vs. 16.0-20.9%) and current depression (36.1% vs. 28.2%). Emotional abuse and neglect contributed the highest PAFs (up to 10.2%). Maltreatment mediated 18.9-30.0% of the association between sex and depression. CONCLUSION: Maltreatment, especially emotional subtypes, account for a substantial proportion of depression in both sexes, with stronger overall associations in women. Sex-specific prevention may help reduce depression prevalence. |
| Keywords: | Cigarette Smoking, Depression, Childhood Abuse, Sex Differences, Epidemiology |
| Source: | medRxiv |
| Publisher: | Cold Spring Harbor Laboratory Press |
| Article Number: | 2026.02.02.26345366 |
| Date: | 3 February 2026 |
| Official Publication: | https://doi.org/10.64898/2026.02.02.26345366 |
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