Abstract
BACKGROUND: Depression and anxiety are among the most prevalent mental disorders globally and represent major public health challenges. The impact of early-life famine exposure on mental health has increasingly drawn attention. However, research on the association between early-life famine exposure and the risk of depression and anxiety in adulthood, especially across different ethnic backgrounds, remains scarce in worldwide. METHODS: The study is based on the baseline data from the China Multi-Ethnic Cohort (CMEC), and includes 18,376 individuals who were born between 1939 and 1978 and experienced early life famine exposure. All participants underwent face-to-face interviews and physical examinations, and their anxiety and depression symptoms were assessed using the PHQ-2 and GAD-2 scales. Multivariable logistic regression analysis was conducted to examine the association between early-life famine exposure and the risk of depression and anxiety in adulthood. RESULTS: The study revealed that exposure to famine during childhood (OR = 1.65, 95% CI: 1.33–2.05, p < 0.001) and adolescence (OR = 1.64, 95% CI: 1.18–2.28, p = 0.003) was associated with an increased risk of depressive symptoms in adulthood, especially among females ( childhood OR = 1.87, 95% CI: 1.47–2.39, p < 0.001; adolescence OR = 1.96, 95% CI: 1.36–2.81, p < 0.001). In the Han ethnic group, childhood famine exposure (OR = 1.92, 95% CI: 1.44–2.56, p < 0.001) was associated with a higher risk of depressive symptoms in later life. In the Yi ethnic group, fetal exposure to famine was associated with an increased risk of both depressive symptoms (OR = 2.33, 95% CI: 1.28–4.25, p = 0.005) and anxiety symptoms in adulthood (OR = 1.99, 95% CI: 1.37–2.88, p < 0.001), whereas no associations were observed in the Bai ethnic group. Regarding anxiety symptoms, males exposed to famine during childhood (OR = 0.53, 95% CI: 0.33–0.85, p = 0.008) and adolescence (OR = 0.32, 95% CI: 0.13–0.78, p = 0.013) had a lower risk of developing anxiety symptoms in adulthood. Among the Yi population, fetal famine exposure was associated with a higher risk of adult anxiety symptoms (OR = 1.99, 95% CI: 1.37–2.88, p < 0.001). CONCLUSION: Famine exposure during childhood and adolescence is associated with altered risks of mental health disorders in adulthood, with patterns varying across ethnic groups. Early-life nutritional deprivation may exert long-term effects on mental health, and these associations appear to differ by gender and ethnicity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07375-1.