Does accumulative childhood trauma affect adult depression? Exploring the mediating effects of substance misuse experience and gender differences

Background: There is a growing global concern of depression, especially notable in South Korea, where childhood trauma significantly elevates the risk of depression and substance misuse in adulthood. This study aims to explore the mediating role of substance misuse within this relationship, emphasizing gender differences. The insights gained from this research aim to inform the development of effective intervention strategies and public health policies. Methods: This study utilizes data from the 2021 Life Events and Trauma Experience Survey conducted in South Korea to explore gender differences in the mediating effects substance misuse on the relationship between childhood trauma and adult depression. The sample comprises 1331 adults who experienced childhood trauma, and depression is assessed using the Patient Health Questionnaire-9 (PHQ-9). Childhood trauma is categorized into 23 life events. Results: The findings indicated that both childhood trauma and substance misuse were significantly associated with increased levels of adult depression, with substance misuse intensifying this effect. Gender differences were observed, as females reported higher levels of both depression and experiences of childhood trauma. However, gender did not influence the mediating effect of substance misuse on depression. Furthermore, factors such as having a spouse, chronic illness, and economic status influenced levels of depression and substance misuse. Conclusions: The findings suggest the need for preventive efforts for childhood trauma and substance misuse interventions, emphasizing a comprehensive approach rather than a gender-specific one in mental health programs.