• Bmc Med · Mar 2023

    Meta Analysis

    Depression, cardiometabolic disease, and their co-occurrence after childhood maltreatment: an individual participant data meta-analysis including over 200,000 participants.

    • Camille Souama, Femke Lamers, Yuri Milaneschi, Christiaan H Vinkers, Serena Defina, Linda Garvert, Frederike Stein, Tom Woofenden, Katharina Brosch, Udo Dannlowski, Henrike Galenkamp, Ron de Graaf, JaddoeVincent W VVWVGeneration R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Anja Lok, Bas B van Rijn, Henry Völzke, Charlotte A M Cecil, Janine F Felix, Hans J Grabe, Tilo Kircher, Karim Lekadir, HaveMargreet TenMTDepartment of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands., Esther Walton, PenninxBrenda W J HBWJHDepartment of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands.Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands.Amsterdam Neuroscience, Mood, Anxi, and EarlyCause consortium.
    • Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands. c.p.souama@amsterdamumc.nl.
    • Bmc Med. 2023 Mar 13; 21 (1): 9393.

    BackgroundChildhood maltreatment is associated with depression and cardiometabolic disease in adulthood. However, the relationships with these two diseases have so far only been evaluated in different samples and with different methodology. Thus, it remains unknown how the effect sizes magnitudes for depression and cardiometabolic disease compare with each other and whether childhood maltreatment is especially associated with the co-occurrence ("comorbidity") of depression and cardiometabolic disease. This pooled analysis examined the association of childhood maltreatment with depression, cardiometabolic disease, and their comorbidity in adulthood.MethodsWe carried out an individual participant data meta-analysis on 13 international observational studies (N = 217,929). Childhood maltreatment comprised self-reports of physical, emotional, and/or sexual abuse before 18 years. Presence of depression was established with clinical interviews or validated symptom scales and presence of cardiometabolic disease with self-reported diagnoses. In included studies, binomial and multinomial logistic regressions estimated sociodemographic-adjusted associations of childhood maltreatment with depression, cardiometabolic disease, and their comorbidity. We then additionally adjusted these associations for lifestyle factors (smoking status, alcohol consumption, and physical activity). Finally, random-effects models were used to pool these estimates across studies and examined differences in associations across sex and maltreatment types.ResultsChildhood maltreatment was associated with progressively higher odds of cardiometabolic disease without depression (OR [95% CI] = 1.27 [1.18; 1.37]), depression without cardiometabolic disease (OR [95% CI] = 2.68 [2.39; 3.00]), and comorbidity between both conditions (OR [95% CI] = 3.04 [2.51; 3.68]) in adulthood. Post hoc analyses showed that the association with comorbidity was stronger than with either disease alone, and the association with depression was stronger than with cardiometabolic disease. Associations remained significant after additionally adjusting for lifestyle factors, and were present in both males and females, and for all maltreatment types.ConclusionsThis meta-analysis revealed that adults with a history of childhood maltreatment suffer more often from depression and cardiometabolic disease than their non-exposed peers. These adults are also three times more likely to have comorbid depression and cardiometabolic disease. Childhood maltreatment may therefore be a clinically relevant indicator connecting poor mental and somatic health. Future research should investigate the potential benefits of early intervention in individuals with a history of maltreatment on their distal mental and somatic health (PROSPERO CRD42021239288).© 2023. The Author(s).

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