A Developmental Perspective on the Relationship between Child Sexual Abuse and Depression: A Systematic and Meta-Analytic Review

It is essential to examine child sexual abuse (CSA) and depression from a developmental perspective. Two meta-analyses were conducted to examine the relationship between CSA and depression pertaining to the age at onset. English and Chinese databases were searched for articles on the association between CSA and depression that were published before December 2016. Random effect models were used in the meta-analyses (35 studies with 37 effect sizes altogether). The result of the first analysis showed that CSA experiences were related to an earlier onset of depression among adult patients with depression with a moderate effect size. This relationship was found to be robust as it was not influenced by any of the moderators except for gender composition of the sample, and no publication bias was detected. The second analysis showed that CSA at a younger age was significantly related to a higher risk for depression in studies with female, adult or clinical/community samples, or where CSA onset was measured as a continuous age variable. The mixed findings between the age at CSA onset and depression caution against the use of a simple linear model. 'Two meta-analyses were conducted to examine the relationship between CSA and depression pertaining to the age at onset' Key Practitioner Messages Screening for child maltreatment experiences should be done routinely for the treatment of depression. Preventive treatment is recommended for young CSA victims even if they do not present with depressive symptoms. Clinicians who work with sexually abused children should consider abuse-specific treatment to reduce the negative effect of earlier depression onset.