Childhood maltreatment and characteristics of adult depression: meta-analysis.

BACKGROUND: Childhood maltreatment has been discussed as a risk factor for the development and maintenance of depression.

AIMS: To examine the relationship between childhood maltreatment and adult depression with regard to depression incidence, severity, age at onset, course of illness and treatment response.

METHOD: We conducted meta-analyses of original articles reporting an association between childhood maltreatment and depression outcomes in adult populations.

RESULTS: In total, 184 studies met inclusion criteria. Nearly half of patients with depression reported a history of childhood maltreatment. Maltreated individuals were 2.66 (95% CI 2.38-2.98) to 3.73 (95% CI 2.88-4.83) times more likely to develop depression in adulthood, had an earlier depression onset and were twice as likely to develop chronic or treatment-resistant depression. Depression severity was most prominently linked to childhood emotional maltreatment.

CONCLUSIONS: Childhood maltreatment, especially emotional abuse and neglect, represents a risk factor for severe, early-onset, treatment-resistant depression with a chronic course.