Send to

Choose Destination
See comment in PubMed Commons below
Psychol Med. 2012 Feb;42(2):409-17. doi: 10.1017/S0033291711001462. Epub 2011 Aug 11.

Childhood sexual abuse and the risk for recurrent major depression in Chinese women.

Cong E1, Li Y2, Shao C1, Chen J3, Wu W4, Shang X5, Wang Z6, Liu Y7, Liu L8, Gao C9, Li Y10, Wu J11, Deng H12, Liu J13, Sang W14, Liu G15, Rong H16, Gan Z17, Li L18, Li K19, Pan J20, Li Y21, Cui Y22, Sun L23, Liu L24, Liu H25, Zhao X26, Zhang Y27, Zhang R28, Chen Y29, Wang X30, Li H31, Chen Y32, Lin Y33, Kendler KS34, Flint J2, Shi S1.

Author information

  • 1Huashan Hospital, Fudan University, Shanghai, P.R. China.
  • 2Wellcome Trust Centre for Human Genetics, Oxford, UK.
  • 3Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
  • 4Tongji Hospital, Shanghai Tongji University, Shanghai, P.R. China.
  • 5Nanjing Brain Hospital, Nanjing, Jiangsu, P.R. China.
  • 6No. 4 Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, P.R. China.
  • 7Tianjin Anding Hospital, Hexi District, Tianjin, P.R. China.
  • 8Shandong Mental Health Centre, Jinan, Shandong, P.R. China.
  • 9No. 1 Hospital of Medical College of Xian Jiaotong University, Xi'an, Shaanxi, P.R. China.
  • 10No. 1 Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China.
  • 11No. 1 Mental Health Centre Affiliated Harbin Medical University, Nangang District, Harbin, Heilongjiang, P.R. China.
  • 12Mental Health Centre of West China Hospital of Sichuan University, Wu Hou District, Chengdu, Sichuan, P.R. China.
  • 13Beijing Anding Hospital, Capital Medical University, Xicheng District, Beijing, P.R. China.
  • 14Hebei Mental Health Centre, Baoding, Hebei, P.R. China.
  • 15Shengjing Hospital of China Medical University, Heping District Shenyang, Liaoning, P.R. China.
  • 16Shenzhen Kangning Hospital, Luo Hu, Shenzhen, Guangdong, P.R. China.
  • 17No. 3 Affiliated Hospital of Sun Yat-sen University, Tian He District, Guangzhou, Guangdong, P.R. China.
  • 18No. 1 Hospital of Shanxi Medical University, Taiyuan, Shanxi, P.R. China.
  • 19Mental Hospital of Jiangxi Province, Nanchang, Jiangxi, P.R. China.
  • 20The First Affiliated Hospital of Jinan University, Tian He District, Guangzhou, Guangdong, P.R. China.
  • 21Wuhan Mental Health Centre, Wuhan, P.R. China.
  • 22No. 3 Hospital of Heilongjiang Province, Beian, Heilongjiang, P.R. China.
  • 23Jilin Brain Hospital, Siping, Jilin, P.R. China.
  • 24The First Hospital of China Medical University, He Ping District, Shenyang, Liaoning, P.R. China.
  • 25Dalian No. 7 People's Hospital and Dalian Mental Health Centre, Gan Jing Zi District, Dalian, Liaoning, P.R. China.
  • 26The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China.
  • 27Lanzhou University Second Hospital, Second Clinical Medical College of Lanzhou University, Lanzhou, Gansu Province, P.R. China.
  • 28Psychiatric Hospital of Henan Province, Xinxiang, Henan, P.R. China.
  • 29The Fourth Military Medical University affiliated Xijing Hospital, Xi'an, Shaanxi, P.R. China.
  • 30No. 4 People's Hospital of Liaocheng, Liaocheng, Shandong, P.R. China.
  • 31Guangzhou Brain Hospital/Guangzhou Psychiatric Hospital, Li Wan District, Guangzhou, Guangdong, P.R. China.
  • 32Clinical Trial Service Unit, Richard Doll Building, Oxford, UK.
  • 33Fuzhou Neuropsychiatric Hospital, Fuzhou City, Fujian, P.R. China.
  • 34Department of Psychiatry, Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA.



Studies in Western countries have repeatedly shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in China?


Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 1970 clinically ascertained with recurrent MD and 2597 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression and regression coefficients by linear or Poisson regression.


Any form of CSA was significantly associated with recurrent MD [OR 3.26, 95% confidence interval (CI) 1.95-5.45]. This association strengthened with increasing CSA severity: non-genital (OR 2.47, 95% CI 1.17-5.23), genital (OR 2.77, 95% CI 1.32-5.83) and intercourse (OR 13.35, 95% CI 1.83-97.42). The association between any form of CSA and MD remained significant after accounting for parental history of depression, childhood emotional neglect (CEN), childhood physical abuse (CPA) and parent-child relationship. Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes and an increased risk for generalized anxiety disorder (GAD; OR 1.92, 95% CI 1.39-2.66) and dysthymia (OR 2.16, 95% CI 1.52-3.09).


In Chinese women CSA is strongly associated with MD and this association increases with greater severity of CSA. Depressed women with CSA have an earlier age of onset, longer depressive episodes and increased co-morbidity with GAD and dysthymia. Although reporting biases cannot be ruled out, our results are consistent with the hypothesis that, as in Western countries, CSA substantially increases the risk for MD in China.

[PubMed - indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Cambridge University Press Icon for PubMed Central
    Loading ...
    Support Center