Early life stress associated with youth-onset depression

Washington - A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that individuals exposed to early life stress (ELS) were more likely to develop a major depressive disorder (MDD) in childhood or adolescence than individuals who had not been exposed to ELS.

Examining the association between eight different types of ELS and youth-onset depression, the authors found that while some types of ELS (e.g., poverty) were not associated with MDD, other types of stress, including emotional abuse, were associated more strongly with MDD than a broader assessment of ELS.

"Researchers have documented that early life stress increases the risk for developing depression in adulthood. We wanted to know the degree to which it was associated with depression earlier in life--specifically during childhood or adolescence," said lead author Joelle LeMoult, PhD, a researcher at the University of British Columbia, Vancouver, Canada. "Given that earlier onsets of depression often mean a more recurrent course across the lifespan. We found that exposure to early life stress more than doubled the likelihood someone will develop youth-onset depression.

"These findings indicate that there is a narrow window between adversity and depression during which we have the opportunity to intervene."

The findings are based on a meta-analysis of data from 62 journal articles and over 44,000 unique participants. Studies that assessed early life stress and the presence or absence of MDD before the age of 18 years were also included.

Compared to youth who were not exposed to ELS, youth who were exposed to ELS were 2.5 times more likely to develop MDD (OR=2.50; 95% CI [2.08, 3.00]).

The authors also conducted eight additional meta-analyses to examine the association between different types of ELS and a diagnosis of MDD during childhood or adolescence. Sexual abuse, physical abuse, death of a family member, domestic violence, and emotional abuse were associated with significantly higher risk for youth-onset MDD; in contrast, poverty, illness/injury, and exposure to a natural disaster were not.

Several variables moderated the association between ELS and youth-onset MDD. For example, studies that used interview-based assessments or included larger sample sizes reported stronger associations between ELS and depression.

Taken together, findings provide evidence that the adverse effects of ELS on risk for MDD manifests early in development, before adulthood, and varies by type of ELS. Further, findings support recommendations to use best-practice methods in early life stress research.

http://dx.doi.org/10.1016/j.jaac.2019.10.011