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| Item Type: | Article |
|---|---|
| Title: | Examining the contribution of childhood maltreatment to the sex gap in Depression: insights from the German National Cohort (NAKO) |
| Creators: |
Völker, Maja P., Kresken, Aina L., Foo, Jerome C., Frank, Josef, Reinhard, Iris, Klinger-König, Johanna, Zillich, Lea, Ferreira de Sá, Diana S., Mikolajczyk, Rafael  ORCID: https://orcid.org/0000-0003-1271-7204, Leitzmann, Michael, Fromherz, Patricia, Krist, Lilian, Keil, Thomas, Meinke-Franze, Claudia, Riedel-Heller, Steffi G., Greiser, Halina, Bohn, Barbara, Brenner, Hermann ORCID: https://orcid.org/0000-0002-6129-1572, Obi, Nadia ORCID: https://orcid.org/0000-0002-0903-9142, Harth, Volker, Pischon, Tobias ORCID: https://orcid.org/0000-0003-1568-767X, Grabe, Hans J., Berger, Klaus, Schwarz, Emanuel ORCID: https://orcid.org/0000-0002-0261-5063, Mata, Jutta, Witt, Stephanie H. and Streit, Fabian
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| Abstract: | INTRODUCTION: 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 maltreatment subtypes. METHODS: We analyzed baseline data from 159,045 participants (49.4% female; aged 19-72) in the German National Cohort (NAKO). Childhood maltreatment was assessed via the Childhood Trauma Screener; depression was assessed 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. Disparity decomposition analyses and sex-stratified population attributable fractions (PAFs) quantified the contribution of childhood maltreatment to depression. RESULTS: Childhood maltreatment was associated with increased odds of lifetime (OR(physician'sdiagnosis) = 2.45 [2.38, 2.53]; OR(MINI) = 2.30 [2.18, 2.43]) and current depression (OR = 2.90 [2.79, 3.02], all p(adj) < 0.001). Sex interactions were observed for physician's diagnosis: physical abuse (p(adj) = 0.024) and neglect (p(adj) < 0.001) had stronger associations in females (OR(physical abuse) = 2.74 [2.59, 2.90]; OR(physical neglect) = 1.36 [1.28, 1.44]) than males (OR(physical abuse) = 2.36 [2.21, 2.52]; OR(physical neglect) = 1.08 [1.00, 1.16]), whereas sexual abuse (p(adj) = 0.003) showed stronger associations in males (OR = 3.23 [2.91, 3.57]) than females (OR = 2.61 [2.48, 2.75]). Overall, childhood maltreatment accounted for 21.2-26.2% of lifetime and 33.4% of current depression. Population attributable fractions were higher in females than males for lifetime (24.5-28.5% vs. 16.0-20.9%) and current depression (36.1% vs. 28.4%). Emotional subtypes contributed the highest PAFs (up to 10.2%). Childhood maltreatment contributed 19.2-22.4% to the association between sex and depression. CONCLUSION: Childhood maltreatment accounts for a substantial proportion of depression in both sexes, with stronger overall associations in females. Sex-specific prevention may help reduce depression prevalence. |
| Keywords: | Depression, Childhood Abuse, Sex Differences, Epidemiology |
| Source: | Psychotherapy and Psychosomatics |
| ISSN: | 0033-3190 |
| Publisher: | Karger |
| Date: | 31 August 2026 |
| Official Publication: | https://doi.org/10.1159/pps/aemag008 |
| PubMed: | View item in PubMed |
| Related to: |
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