Associations Between Child Maltreatment, Inflammation, and Comorbid Metabolic Syndrome to Depressed Mood in a Multiethnic Urban Population: The HELIUS Study

Abstract

BackgroundChild maltreatment is a common negative experience and has potential long-lasting adverse consequences for mental and physical health, including increased risk for major depressive disorder (MDD) and metabolic syndrome. In addition, child maltreatment may increase the risk for comorbid physical health conditions to psychiatric conditions, with inflammation as an important mediator linking child maltreatment to poor adult health. However, it remains unresolved whether experiencing child maltreatment increases the risk for the development of comorbid metabolic syndrome to MDD. Therefore, we investigated whether child maltreatment increased the risk for comorbid metabolic syndrome to depressed mood. Subsequently, we examined whether C-reactive protein (CRP), as an inflammatory marker, mediated this association. In addition, we investigated whether effects differed between men and women.MethodsAssociations were examined within cross-sectional data from the multiethnic HELIUS study (N = 21,617). Adult residents of Amsterdam, Netherlands, self-reported on child maltreatment (distinct and total number of types experienced before the age of 16 years) as well as current depressed mood (PHQ-9 score ≥ 10), and underwent physical examination to assess metabolic syndrome. The CRP levels were assessed in N = 5,998 participants. Logistic and linear regressions were applied for binary and continuous outcomes, respectively. All analyses were adjusted for relevant demographic, socioeconomic, and lifestyle characteristics, including ethnicity.ResultsA higher number of maltreatment types as well as distinct types of emotional neglect, emotional abuse, and sexual abuse were significantly associated with a higher risk for current depressed mood. Child maltreatment was not significantly associated with the risk for metabolic syndrome in the whole cohort, nor within individuals with depressed mood. As child maltreatment was not significantly associated with the CRP levels, subsequent mediation analyses were not performed. No significant moderating effects by sex were observed.ConclusionIn this multiethnic urban cohort, child maltreatment was associated with a higher risk for depressed mood. Contrary to our expectations, child maltreatment was not significantly associated with an increased risk for metabolic syndrome, neither in the whole cohort nor as a comorbid condition in individuals with depressed mood. As the data were cross-sectional and came from a non-clinical adult population, longitudinal perspectives in relation to various stages of the investigated conditions were needed with more comprehensive assessments of inflammatory markers.

The Healthy Life in an Urban Setting (HELIUS) study in Amsterdam, The Netherlands: cohort update 2024 and key findings

“…In general these disparities reflect an increased risk in those with a migration background, with the exception of regular alcohol use, which is more common in those with Dutch origin (69). Disparities were also observed in proximal risk factors for depressed mood, including childhood maltreatment (70,71). The prevalence of any type of childhood maltreatment ranged from 24% in the Moroccan origin group to 39% in the African Surinamese group, with generally higher rates in women than in men.…”

Individual and neighborhood determinants of depressive symptoms in ethnic minorities in the urban HELIUS sample: a multi-level network perspective

“…Childhood adverse life events were assessed with the NEMESIS trauma questionnaire (De Graaf, Ten Have, & Van Dorsselaer, 2010), which consists of 4 items, each representing distinct forms of maltreatment (i.e., emotional neglect as well as physical, sexual, and emotional abuse) encountered before the age of 16. The four items were aggregated into one (see also Willemen et al, 2022, for the aggregation approach).…”