Abstract
BACKGROUND: Adverse childhood experiences (ACEs) are known to be associated with depression. However, the extent to which such association varies by age at the first occurrence of ACEs remains unexplored. The objectives of this study are: (1) To describe the association between ACEs and depression among university students in China, and; (2) to assess the extent to which the mentioned association varied by age at first ACE. METHODS: We conducted a self-administered survey among university students in southern China and analyzed the data using descriptive statistics and multivariate logistic regression. RESULTS: We found significant associations between ACEs and depression prevalence, particularly when comparing students with three or more ACEs vs. students with no ACEs (62% vs. 36%; Adjusted OR = 3.49; 95% CI = 1.99, 6.12). Stratified analyses showed that the association was particularly strong among students who first experienced ACEs at age 0-6 years (66% vs. 36%; Adjusted OR = 4.05; 95% CI = 1.90, 8.59), but was non-significant among those who first experienced ACEs at age 13-18 years (31% vs. 36%; Adjusted OR = 0.99; 95 CI = 0.24, 4.08). CONCLUSION: The strength of the associations between ACEs and depression varied by the age at first ACE. However, the cross-sectional study design, potential information bias, and lack of generalizability should be considered as caveats in the interpretation of the study findings.