Substantial evidence indicates that experiencing physical abuse and neglect during childhood significantly elevates the likelihood of developing depression in adulthood. Nevertheless, there remains a dearth of understanding regarding the mechanisms underpinning this correlation. In this study, we aimed to examine the associations of childhood physical abuse and physical neglect with depression using follow-up data from UK Biobank and quantified the contribution of smoking, insomnia, and BMI in these associations. This study included 144,704 participants (64,168 men and 80,536 women) from UK Biobank, most of whom were white (97 %). Physical abuse and physical neglect were measured using two items of Childhood Trauma Screener (CTS). Data on the incidence of depression were obtained from primary care, hospital inpatient records, self-reported medical conditions, and death registries. We used a sequential mediation analysis based on the “g-formula” approach to explore the individual and joint effects of potential mediators. The depression incidence rate was 1.85 per 1000 person-years for men and 2.83 per 1000 person-years for women, respectively. Results of Cox proportional risk regression showed that physical abuse (HRs: 1.39–1.53, < 0.001) and physical neglect (HRs: 1.43–1.60, < 0.001) are associated with depression. Smoking, insomnia, and BMI together mediated 3 %–26 % of the associations. These findings contribute to our understanding of how physical abuse and physical neglect influence depression. Furthermore, a more effective reduction in the burden of depression can be achieved by managing modifiable mediators.

中文翻译：

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解释童年身体虐待和身体忽视如何影响成年抑郁症：使用多个顺序中介变量的分析

大量证据表明，童年时期遭受身体虐待和忽视会显着增加成年后患抑郁症的可能性。然而，对于支撑这种相关性的机制仍然缺乏了解。在这项研究中，我们旨在利用英国生物银行的后续数据来研究儿童身体虐待和身体忽视与抑郁症的关联，并量化吸烟、失眠和体重指数在这些关联中的贡献。这项研究包括来自英国生物银行的 144,704 名参与者（64,168 名男性和 80,536 名女性），其中大多数是白人 (97%)。使用儿童创伤筛查（CTS）的两项来测量身体虐待和身体忽视。抑郁症发病率的数据来自初级保健、医院住院患者记录、自我报告的医疗状况和死亡登记。我们使用基于“g-公式”方法的序贯中介分析来探索潜在中介的个体和联合效应。男性抑郁症发病率为每1000人年1.85例，女性抑郁症发病率为每1000人年2.83例。 Cox比例风险回归结果显示，身体虐待（HR：1.39-1.53​​，<0.001）和身体忽视（HR：1.43-1.60，<0.001）与抑郁症相关。吸烟、失眠和体重指数共同介导了 3%–26% 的关联。这些发现有助于我们了解身体虐待和身体忽视如何影响抑郁症。此外，通过管理可改变的中介因素可以更有效地减轻抑郁症的负担。