Abstract P294: The Chinese Great Famine and Major Depression Disorder: the CHARLS study

Objectives: To estimate the prevalence of major depression and experience severe famine during the Chinese Great Famine in middle-aged and older Chinese population, and to evaluate the impact of famine experience on risk of major depression in late adulthood. Methods: We estimated the prevalence of major depression and severe famine in participants of the China Health and Retirement Longitudinal Study (CHARLS). CHARLS surveyed a representative sample of 17,708 middle-aged and older Chinese adults. SAS PROCFREQ procedure was applied to estimate famine and depression prevalence taking into account the survey design and responding rate. Depression was measured using Center for Epidemiological Studies Depression Scale (CES-D) short form. Famine was based on self-report, and was categorized into none, slight, moderate, and severe. We evaluated famine experience and major depression risk in late adulthood in cohorts of different development stages when famine occurred, using logistic regression adjusting for important demographic, socioeconomic, biomedical, and chronic comorbidities. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) are presented. Results: A total of 11.60% of the middle-aged and older Chinese adults experienced severe famine in 1959-1961. Famine significantly increased risk of major depression in late adulthood among those who experienced famine during fetal, mid-childhood, young teens, and adulthood. Compared to those who did not experience famine, those with severe famine experience were 3.00 (95% CI: 1.53-5.89), 1.94 (95% CI: 1.39-2.71), 1.89 (95% CI: 1.15-3.10), and 2.32 (95% CI: 1.62-3.32) times more likely to have major depression in late adulthood among the fetal, mid-childhood, young teens, and adulthood cohorts, respectively. Even adjusting for all variables, there are still significant trends between famine severity and risk of major depression. However, famine experience was not associated with late adulthood depression risk among infant, toddler, preschool, or teenagers cohorts. Conclusion: More than 11.6% of the Chinese population experienced severe famine. Exposure to famine during fetal, mid-childhood, young teens, and adulthood stages increased risk of depression in late adulthood.