New meta-analysis led by Dr. Joelle LeMoult finds that individuals exposed to early life stress (ELS) were more than twice as likely to develop a major depressive disorder (MDD) in childhood or adolescence than youth who were not exposed to ELS.
The study, Meta-analysis: Exposure to Early Life Stress and Risk for Depression in Childhood and Adolescence, was published recently in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).
To examine the factors that contribute to MDD risk in youth, LeMoult, an assistant professor in the department of psychology at UBC, analyzed data from 62 journal articles and over 44,000 participants.
“Our findings imply that the adverse effect of early life stress on MDD risk manifests early in development, before adulthood. Thus, early intervention is imperative.”
“Our findings imply that the adverse effect of early life stress on MDD risk manifests early in development, before adulthood. Thus, early intervention is imperative,” says LeMoult. “There is also the potential that findings from this meta-analysis might encourage a precision-medicine approach to preventions for MDD following ELS that take into account the type of ELS.”
LeMoult joins us for a Q&A to discuss the findings of this research—and how it could help treat individuals who have experienced early life stress.
What is this study about?
We quantified the degree to which early life stress (ELS) was associated with the onset of Major Depressive Disorder (MDD) in childhood or adolescence. To do so we conducted a meta-analysis of data from 62 journal articles and over 44,000 unique participants.
What do the findings show?
We found that youth who were exposed to ELS were 2.5 times more likely to develop MDD in childhood or adolescence than were youth who were not exposed to ELS. We also found that the type of ELS youth were exposed to influenced the likelihood of developing MDD. Whereas some types of ELS (e.g., poverty, natural disaster) were not associated with MDD, other types (e.g., emotional abuse, death of a family member) were associated more strongly with developing MDD than was all types of ELS considered together.
Why did you feel compelled to do this meta-analysis?
As many as 25% of adolescents meet criteria for MDD, which has long-term consequences for youth’s physical health, social and economic wellbeing, and risk for recurrent depressive episodes. We wanted to identify factors that contribute to risk for MDD in youth. Several recent meta-analyses have shown that ELS increases risk for MDD in adults, but the nature of the association between ELS and MDD had not been quantified in youth. Given differences between youth and adults in the etiology, presentation, and course of depression, we were motivated to quantify the association between ELS and childhood- or adolescent-onset MDD.
What are the implications?
Our findings imply that the adverse effect of ELS on MDD risk manifests early in development, before adulthood. Thus, early intervention is imperative. Our findings also imply that different types of ELS confer different degrees of risk for MDD. It is therefore important to better understand the mechanisms through which exposure to ELS increases individuals’ risk for depression versus other types of impairment.
How could this research help treat individuals who have experienced early life stress?
Given that the interval is short between ELS exposure and MDD onset, there is a narrow window following ELS to intervene. We hope that this evidence prompts improved efficacy and dissemination of clinical interventions for youth who have been exposed to ELS. There is also the potential that findings from this meta-analysis might encourage a precision-medicine approach to preventions for MDD following ELS that take into account the type of ELS.
Joelle LeMoult
Dr. Joelle LeMoult is the director of the Depression, Anxiety, and Stress Laboratory, a Michael Smith Foundation for Health Research Scholar, and a registered clinical psychologist.
The overarching goal of her research is to further our understanding of the onset, maintenance, and treatment of depressive and anxiety disorders in adolescents and adults. Using a multimodal approach, she examines the cognitive, emotional, and biological responses to environmental stressors that contribute to depression and anxiety.
