#45 Childhood adversity and the onset, recurrence, and remission of major depression

PURPOSE: Childhood adversity significantly increases the risk of depression, but it is unclear whether such risk is most pronounced early in life. In the present study, we examine whether childhood adversity—indicated by parental socioeconomic status (SES), family disruption, and residential instability—is related to an increased risk of depression during specific stages of the life course; in addition, we analyze the association between childhood adversity and the subsequent course of major depression. METHODS: A sample of 1,089 of the 4,140 births enrolled in the Providence (Rhode Island) site of the National Collaborative Perinatal Project was interviewed between the ages of 17 and 39. Measures of childhood risks were obtained before birth and at age seven. Ages at onset, offset, and number of lifetime depressive episodes were ascertained via structured diagnostic interviews. Survival analyses were used to identify risk factors for depression onset and remission, and Poisson regression was used to model the recurrence rate of depressive episodes. RESULTS: By the age of 7, low parental SES, divorce, and a high level of residential instability, defined as 3 or more family moves, were related to elevated lifetime risks of depression; the effects of parental divorce and residential instability were most pronounced for depression onset by age 14. Childhood adversity was also related to increased risk of recurrence and reduced likelihood of remission. CONCLUSION: Childhood social disadvantage has long term consequences for the onset of major depression; however, the duration of risk associated with the childhood environment varies, and may diminish with time. Early childhood adversity also predicted poor prognosis independent of its effects on early onset depression.