The impact of childhood parental loss on risk for depression and anxiety in adulthood: A community-based study in Southwest China

Purpose: Lack of parental raising is an important reason for parental loss in China due to urbanization. We aimed to explore the association between parental loss (including parental death, divorce, alcoholism, crime, drug addiction, bedridden, and lack of parental raising) before 17 years old and mental health disorders in adulthood in Southwest China. Methods: Childhood parental loss, age, gender, socioeconomic status, smoking, drinking, and medical history were self-reported. Patient Health Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) were used for identifying depression and anxiety, respectively. We use logistic regression with inverse probability weighting according to the propensity score to assess the risk of childhood parental loss on mental health disorders in adulthood. Results: A total of 8014 adults were enrolled in this study. Childhood parental loss increased the risk of adulthood depression (OR, 1.60, 95%CI, 1.30-1.98) but not anxiety (p=0.07) after adjustment of all covariates. Sensitivity analyses including logistic regression with original data, nearest neighbor matching, full matching, and propensity score as the only covariate all yielded similar results. Limitations: Recall bias could not be fully eliminated due to the retrospective nature of study design. Our study had been conducted in a less-prosperous area in Southwest China and the results may not be representative at nation level. Conclusions: Childhood parental loss was associated with depression in adulthood in Southwest China, highlighting the need for early intervention in children with parental loss, to prevent long-term negative effects on their mental health.