Adversity, hunger and early-life depression: 2 reports


Early adversity, notably during key periods of development, significantly increases the risk of major depressive disorder in children/adolescents, according to two recent studies.

An analysis of Danish national registries (n=978,647) examined the relationship between adverse life events and onset of depression prior to age 15 years (Dahl et al. J Affect Disord 2017;214:122-129).

The types of adversity were parental events (illness, incarceration, death, disability, psychiatric diagnosis), family disruption, out-of-home care, and childhood abuse. All adverse events were associated with an increased risk of moderate-to-severe depression (hazard ratio 1.30 to 2.72). The timing of adverse events was significant: depression risk was highest for family disruption before age 5 (hazard ratio 1.66); and for out-of-home care for ages 10 to 14 years (hazard ratio 2.45).

Researchers at the University of Calgary used data from the National Longitudinal Survey of Children and Youth to examine the relationship between hunger and major depression (McIntyre et al. Soc Psychiatry Psychiatr Epidemiol 2017; epublished March 11, 2017). The dataset was adolescents aged 16 years or older (n=4,139). The prevalence of self-reported hunger during childhood/adolescence was 5.9%. Subjects reporting hunger had an increased risk of depression (adjusted odds ratio 2.31) compared to those reporting no hunger experience. A further noteworthy finding was that depression risk remained elevated over time in ever-hungry adolescents.

The Calgary group previously reported that hunger during childhood was a strong predictor of depression and suicidal ideation, even after adjusting for confounds (odds ratio 2.3) (McIntyre et al. J Affect Disord 2013;150:123-129). Hunger was also associated with poorer general health, with poorer long-term health outcomes in girls (Kirkpatrick et al. Arch Pediatr Adolesc Med 2010;164:754-762).

A U.S. study reported similar findings in a study of low-income or homeless mothers and their children (Weinreb et al. Pediatrics 2002;110:e41). Anxiety scores in school-aged children who had experienced severe hunger were two-fold higher than those for children with no hunger. Severe hunger was also associated with high levels of chronic illness, anxiety/depression and internalizing behaviour in preschoolers and school-aged children after controlling for stressful life events, housing status, and maternal distress.

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