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Childhood adversity, adulthood adversity and suicidal ideation in Chinese patients with major depressive disorder: in line with stress sensitization

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Abstract

The stress sensitization model indicates that early adversity (e.g., childhood stress) sensitizes individuals to subsequent proximal stress (e.g., stressful life events in adult life), thereby increasing their vulnerability to psychiatric disorders. However, the effect of stress sensitization on suicidality in patients with major depressive disorder (MDD) has not been previously investigated. Data for the present study were derived from the Objective Diagnostic Markers and Personalized Intervention in MDD Patients (ODMPIM) study. The psychiatric diagnosis and suicidal ideation were evaluated by the Mini‐International Neuropsychiatric Interview (M.I.N.I.). We used a multiple logistic analysis to examine the association among childhood adversity (CA), adulthood adversity (AA) and suicidal ideation. Among 1084 MDD patients, 48.6% had suicidal ideation and 65.6% experienced life adversity during their childhood or adulthood. Patients who reported suicidal ideation were more likely to report CA (46.7% vs. 38.7%, P = 0.008) or AA (49.5% vs. 40.9%, P = 0.004) than patients without suicidal ideation. Patients who experienced two waves of adversity (both CA and AA) were associated with higher rates of suicidal ideation (odds ratio = 1.68, 95% CI = 1.19–2.37, P = 0.003); however, neither CA nor AA alone was associated with suicidal ideation. This study first verifies the hypothesis of stress sensitization on suicidal ideation in patients with MDD. Focusing on stress sensitization may enhance the early identification of MDD patients at suicidal risk and the ability to provide timely and appropriate intervention. Clinicaltrials.gov identifier: NCT02023567.

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Acknowledgements

None.

Funding

This study was supported by grants from the National Key Basic Research Program of China (973 Program) (No. 2013CB531305), the National Key Technology R and D Program (No. 2015BAI13B01), the National Natural Science Foundation of China (No. 81630031), the Beijing Municipal Science and Technology Project (No. Z171100000117016), and the Capital Medical Development Research Fund (2020–2-4113).

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Author notes

  1. Jingyu Lin and Yunai Su contributed equally to this work.

Authors and Affiliations

  1. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital, Beijing, 100101, China

    Jingyu Lin, Yunai Su, Xiaozhen Lv, Qi Liu, Xin Yu & Tianmei Si

  2. Beijing Anding Hospital, Capital Medical University, Beijing, China

    Gang Wang

  3. Peking Union Medical College (PUMC), Beijing, China

    Jing Wei

  4. First Hospital of China Medical University, Shenyang, China

    Gang Zhu

  5. Dalian Seventh People’s Hospital, Dalian, China

    Qiaoling Chen

  6. Tianjin Anding Hospital, Tianjin, China

    Hongjun Tian

  7. Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China

    Kerang Zhang

  8. First Hospital of Hebei Medical University, Shijiazhuang, China

    Xueyi Wang

  9. Tianjin Medical University General Hospital, Tianjin, China

    Nan Zhang

  10. 306Th Hospital of PLA, Beijing, 100101, China

    Hong Yan

  11. 984Th Hospital of PLA, Beijing, China

    Ying Wang

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  1. Jingyu Lin
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Correspondence to Yunai Su or Tianmei Si.

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Lin, J., Su, Y., Lv, X. et al. Childhood adversity, adulthood adversity and suicidal ideation in Chinese patients with major depressive disorder: in line with stress sensitization. Eur Arch Psychiatry Clin Neurosci 272, 887–896 (2022). https://doi.org/10.1007/s00406-021-01375-4

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