The Protective Role of Childhood Friendship on the Effects of Parental Depressive Symptoms and Adult Depressive Symptoms among People with Cardiovascular Disease

The Protective Role of Childhood Friendship on the Effects of Parental Depressive Symptoms and Adult Depressive Symptoms among People with Cardiovascular Disease | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The Protective Role of Childhood Friendship on the Effects of Parental Depressive Symptoms and Adult Depressive Symptoms among People with Cardiovascular Disease Ruoyun Yin, Hongxia Cai, Huan Xiong, Xiujuan Yang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4548466/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Individuals whose parents had depressive symptoms in childhood are more likely to develop depressive symptoms in adulthood than the general population. Few studies have explored the association between the above two in patients with cardiovascular disease(CVD). In addition, it is not clear whether childhood friendship plays an intermediary role between childhood parents' depressive symptoms and adult depressive symptoms. Methods In our study, we selected people suffering from CVD who participated in the China Health and Retirement Longitudinal Study (CHARLS) life history survey and 2018 wave of CHARLS national baseline survey. We made statistical analysis on the assumption that childhood friendship was the mediator between childhood parental depression and adult depressive symptoms. Multi-level logistic regression analysis and Sobel Goodman mediation test were used to measure the association between childhood parental depression, childhood friendship and adult depressive symptoms. Results A total of 5565 participants were included in our study. The proportion of people with CVD having significant depressive symptoms accounted for 43.94%, which was higher than that of total population in the same period(36.62%, p <0.05). The results of logistic regression analysis showed that childhood parental depressive symptoms increased the risk of adult depressive symptoms(Model 3, OR : 1.621, 95% CI : 1.387–1.895). In contrast, childhood friendship was a protective factor for adult depressive symptoms (Model 3, OR : 0.788, 95%CI: 0.685–0.906), and played an intermediary role between childhood parental depressive symptoms and adult depressive symptoms. Through the Sobel-Goodman test, we found that the mediating effect of childhood friendship between the other two accounted for 6.14% of the total effect ( p < 0.001). Conclusions In middle-aged and elderly Chinese with CVD, childhood friendship is a protective factor of adult depressive symptoms, and it is the mediator between childhood parental depression and adult depressive symptoms. Health sciences/Medical research/Epidemiology Health sciences/Risk factors Childhood parental depressive symptoms Childhood friendship Depressive symptoms Cardiovascular disease China Figures Figure 1 Figure 2 1. INTRODUCTION Depression is one of the diseases with the highest prevalence in the global population, which has caused great disease burden. World Health Organization predicted that major depression would become the primary cause of global disease burden by 2030 [1] . According to a global disease survey in 2016, more than 34 million all-age disability-adjusted life-years (DALYs) could be attributed to depression [2] . Compared with that of the world level, the present situation of depression in China is also severe. A meta-analysis showed that the prevalence of depression among Chinese children and adolescents in different regions was about 20% [3] . And the result of a survey on depression among the elderly in China found that the depression prevalence among the study population was 38.5% [4] . It shows that the prevalence of depression is high in different Chinese populations. So, it is of great practical significance to study the prevention of depression. In order to prevent the occurrence of depressive symptoms more specifically, it is important to understand the occurrence and development of depressive symptoms and to identify the relevant influencing factors during this period [5] . It needs to be clear that the occurrence of depressive symptoms is the accumulation of related events in the whole life cycle [6] . Experiences in childhood and adulthood could affect the development of later depressive symptoms [5, 7] . At present, relevant studies often focused on the influencing factors of adulthood. For the general population, researchers often consider the effects of life events in adulthood on depressive symptoms including stress, burnout et al. [5] . For people with disease, the disease condition, medication and life quality are the focus of attention [5, 8] , while the Experiences in childhood are less studied. However, childhood is a critical period for the health development of individual psychology. Related studies have found that childhood life events contributed to adult depressive symptoms [9] . The mental state of long-term contact objects in childhood also affected the occurrence and development of individual depression symptoms [10] . For children, parents might be the people with the highest contact frequency. Parents with depressive symptoms might influence their children in many ways. From the perspective of psychiatry, some mental diseases, such as depression, schizophrenia, anxiety, have certain genetic tendencies [11–13] . From a psychological point of view, people are more susceptible to their parents' influence in childhood. Individual behaviors and thoughts reflected in adulthood have something in common with their parents to a certain extent. When parents existed mental problems, it meaned that they might have difficulties on taking care of their children, such as lower enthusiasm, over-participation, disgust, abuse and over-supervision [14–16] . These may directly or indirectly affect the mental health of their children in adulthood. Based on lifelong epidemiological studies, parents with depressive symptoms might have poor financial conditions and living habits, and they shared such a living environment with their offspring. All of these factors might be associated with adult depression [7, 17] . Related study showed that the people contacting with parents with depressive symptoms in childhood had a higher risk of adult depressive symptoms than the non-contacts [17] . Many studies supported this conclusion [18, 19] . In addition, parents' depressive symptoms in individuals’ childhood not only increases the risk of adult depressive symptoms in offspring, but also makes the individual's treatment effect on depressive symptoms worse [20] . Overall, childhood parental depressive symptoms is a relatively clear risk factor for adult depressive symptoms. However, there are still some points to discuss about the childhood parents' depressive symptoms and individual adult depressive symptoms. Firstly, what are the factors that may moderate or mediate between the two? Secondly, whether parents' depressive symptoms in childhood are still the influencing factors of adult depressive symptoms after adjusting the relevant factors in adulthood? Thirdly, the existing studies tend to focus on the general population, specific age groups (children, adolescents, the elderly) and people with chronic diseases. In certain disease groups, is childhood parental depressive symptoms still a risk factor for adult depressive symptoms? People with cardiovascular diseases(CVD) are a high-risk group suffering from depression. Moreover, depressive symptoms and CVD often coexist [21–23] . Studies have shown that the prevalence of CVD in different groups was from 20–45%, which is higher than that of the general population of the same age [24] . In patients with some kinds of heart diseases, depressive symptoms is even more serious. Related study found that 71.4% of women and 60.4% of men had symptoms of depression or anxiety in people with myocardial infarction(MI) [25] . However, it is different from the general population. The studies on depressive symptoms in patients with CVD often focus on the related factors after the occurrence of the disease [8] . At present, there is few studies exploring on the influence of childhood-related factors on adult depressive symptoms in patients with CVD. We want to explore a protective mediator between childhood parental depressive symptoms and depressive symptoms in adulthood. However, in recent years, studies are more likely to consider some risk factors as mediator s, such as rumination, emotion regulation and negative life events [10, 26, 27] . In fact, protective and risk factors are equally important. In some depression-related studies on the mediating role, friendship is often regarded as a protective mediator. A longitudinal survey on child abuse and neglect found that depression and friendship were related to suicidal ideation in late adolescence, and friendship was the protective factor of the other two [28] . The result of an adolescent study showed that adolescent friendship /family support mediated between boys' and girls' early life stress and late adolescent depressive symptoms [29] . Therefore, friendship might also be a mediator between childhood parents' depressive symptoms and offspring's depressive symptoms in adulthood. The purpose of our study is to clarify the possible relationship among childhood parents' depressive symptoms, friendship and adult depressive symptoms. 2. METHODS 2.1 Participants Based on the published data of the China Health and Retirement Longitudinal Study(CHARLS) conducted by Peking University, we studied the relationship among childhood parental depressive symptoms, childhood friendship and adult depressive symptoms among people over 45 years old with CVD. CHARLS is the first nationally representative cohort study for the middle-aged and elderly Chinese population. Since the first national baseline survey in 2011, CHARLS has followed up the previous survey population every 2–3 years. So far, CHARLS has conducted four national baseline surveys in 28 provinces, 150 regions and 450 villages/communities in China [30] . CHARLS released the latest 2018 wave of the national baseline survey data in 2020. CHARLS life course survey is a life history research in 2014, aiming at collecting the data of the past educational experience, family, economy and health of the study population. This study used the data from both the life history survey and the 2018 wave of CHARLS national baseline survey. A total of 8971 people with CVD participated in the CHARLS national baseline survey in 2018. After excluding the individuals who had incomplete part of the Center for Epidemiologic Studies Depression Scale (CES-D, n = 670) or missing baseline characteristic data(n = 1730), there were 6571 people left. Among them, a total of 5565 people who participated in the life course survey and had complete needed data were included in our study (Fig. 1 ). Our study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline [31] . 2.2 Measures 2.2.1 Cardiovascular disease The information on the disease part is collected through the participants’ self-report. In the survey, the questions related to the condition of CVD included the following two: Have you been diagnosed with hypertension(question 1)/heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems(question 2) by a doctor? In our study, participants who answered "yes" to any of these questions were judged to have CVD. Some related studies have adopted similar judgment methods [32, 33] . 2.2.2 Parental depressive symptoms In the life course survey, CHARLS collected information about the mental state of the participants' parents during participants' childhood(before the age of 17). This part of the survey mainly includes two aspects: ①whether the parents had depressive symptoms in the interviewees’ childhood: During the years you were growing up, had your male/female guardian showed continued signs of sadness or depression that lasted 2 weeks or more?; ②persistent frequency of depressive symptoms: Was this problem of your male/female guardian, sadness or depression during all, most, some, or only a little of your childhood? According to the standard of International Classification of Diseases-10 (ICD-10), depression can be judged if symptoms such as upset, loss of interest and pleasure, lack of energy or fatigue and other common symptoms of depression persist for more than two weeks. Many studies have used ICD-10 as a criterion for judging depression [34, 35] . In CHARLS life course survey, information about parents' mental condition was collected through participants' recollection. Many specific symptoms related to depression of parents during participants' childhood have been difficult to obtain. So, after considering the actual situation and ICD-10 diagnostic principles, we judged the parent who had sad or depressed symptoms most of the time in participant’ childhood as suffering from depression. 2.2.3 Adult Depression Symptom 10-item Center for Epidemiologic Studies Depression Scale(CES-D 10)was used to investigate the depression of the study population. CES-D 10 is a simplified version based on CES-D 20 [36] , which is suitable for screening depression symptoms of the elderly [37, 38] . The scale mainly includes 10 items related to emotional symptoms, with scores ranging from 0 to 30. Previous studies have identified people who scored more than 10 in the CES-D 10 as having significant depressive symptoms [39] . Our study chose the same method of judgment. 2.2.4 Childhood friendship Friendship is a psychological concept, which refers to maintaining a relaxed and harmonious relationship with friends. Therefore, some studies regard "whether to have friends" or "whether to have a happy memory with friends" as the criterion for judging friendship [40] . In the investigation of childhood friendship, participants were asked “When you were a child, did you often have a group of friends that you felt comfortable spending time with? Is it often, sometimes, not very often or never?”. We judged individuals who often/sometimes played with friends as having friendship in childhood. 2.2.5 Control variables in the baseline survey In order to control the possible influence of other depression-related factors on the analysis, it is necessary to include the adjusting factors. It was mainly divided into three categories: baseline characteristics, depression-related factors in childhood and adulthood. The baseline characteristic data of gender, age, education level and marital status were collected through participants' self-reports, and secondly confirmed by using the relevant documents. Age was divided into two categories, bounded by 65. Participants' marital status was divided into married, unmarried, and others (separation, divorce, and widowhood). The education level was divided into two categories: ”lower secondary school and above” and “upper secondary school and below”. Some studies based on CHARLS data adopted the same division method [4, 41] . The depression-related factors in childhood included childhood family economic status, physical abuse and social support. The economic level of childhood was determined by comparing with the economic situation of the surrounding people in the same period. In early China, this way of judging economic level had more reference value than judging by amount, and the recall bias was smaller. Childhood financial situations(before the age of 17) were classified into “worse than others”, “same as others” and “better than others”. Some studies used the same classification method [4] . Using the Adverse Childhood Experience-International Questionnaire (ACE-IQ) as a reference [42] , we judged physical abuse. Physical abuse was determined as long as the participant was beaten in childhood by either of the male guardian/female guardian/siblings at a certain frequency(often, sometimes). The help willingness of people around participants in childhood reflected the social support they received to some extent. Childhood physical abuse, financial condition and social support are common influencing factors of depressive symptoms [5] . The depression-related factors in adulthood included alcohol use, combined with other chronic diseases, and self-reported health. Drinking was a two-category variable, which was determined according to whether there was drinking behavior more than once a month in the past 12 months. In CVD patients, disease condition and self-reported health were related factors of depressive symptoms. 2.3 Statistical analysis Subsequent analysis included descriptive statistics of related factors, logistic regression analysis to examine mediation effect and Sobel-Goodman mediation test. In the descriptive statistics section, mean(M) and standard deviation(SD) were used to describe the distribution of continuous variables such as age and CES-D 10 scores in the study population. In order to facilitate the later analysis, all the factors involved in the study were set as classified variables. We calculated the distribution of various factors in terms of population and gender, and presented them in the form of a table. Next, we analyzed the relationship among childhood parental depressive symptoms, childhood friendship and adult depression symptoms. We assumed that childhood friendship was a mediator between childhood parental depression and adult depressive symptoms. The relationship among them was shown in Fig. 2 : Path A: childhood parental depression can influence childhood friendship; Path B: childhood friendship can influence adult depressive symptoms; Path C: childhood parental depression can influence adult depressive symptoms. All the following analyses were based on this assumption. According to Baron and Kenny's method, childhood friendship is the mediator between childhood parents' depressive symptoms and adult parents' depressive symptoms based on establishment of the above three paths. When the relationship between parental depressive symptoms and childhood friendship is relatively stable, childhood friendship might be considered as a mediator rather than a moderator. If the above hypothesis is not established, the childhood friendship will be verified again as a moderator. Before the logistic regression analysis, we carried out the multi-collinearity analysis to ensure that there was no collinearity among the factors included in the models. The specific steps of the analysis were as follows: 1) to analyze the relationship between childhood parents' depressive symptoms and adult depressive symptoms; 2) to analyze the relationship between childhood friendship and adult depressive symptoms; 3) to analyze the relationship between childhood parents' depressive symptoms and childhood friendship; 4) to analyze the relationship between childhood parents' depressive symptoms, childhood friendship and adult depressive symptoms. Multi-level logistic regression was applied to each step of the above analysis. By comparing the changes of OR (95% CI ) among the models with different factors, the actual role of related factors in the model was determined. Meanwhile, we used Sobel-Goodman mediation test to measure the mediating effect of childhood friendship. The odds ratio ( OR ) and 95% confidence interval (95% CI ) were reported in correlation analysis. Two-tailed p < 0.05 showed there was statistical significance. SPSS 20.0 and STATA 15.0 were used for statistical analysis. 2.4 Ethics approvals Before conducting each investigation of CHARLS, it was approved by the Institutional Review Board at Peking University. The major household surveys involved in CHARLS were approved by the Institutional Review Board(IRB) with the number of IRB00001052-11015. All researches were conducted with the knowledge of the respondents. Participants who have signed informed consent could be included in CHARLS. Our study is a secondary data analysis that is based on CHARLS data shared by Peking University on a public platform. According to relative regulations, secondary analysis based on public data is not subject to ethical approval or informed consent. Our study has been performed in accordance with the Declaration of Helsinki. 3. RESULTS 3.1 Participants’ characteristics in study We conducted a study on the population over 45 years old with CVD in China. After screening, a total of 5565 eligible participants were included in our study. Among them, the male accounted for 35.70% of the study population. The mean(standard deviation, SD) age of the population was 64.33(9.67). In the part of CES-D 10 survey, the mean (SD) score was 9.64(6.91), and 43.94% scored 10 points or more. In the 2018 wave of CHARLS national baseline survey, compared with that in the total population (36.62%), the population with CVD (43.94%) had a higher proportion of significant depressive symptoms ( p <0.05). With regard to the participants' childhood survey, the results showed that 16.96% participants’ parents existed the depressive symptoms during participants’ childhood. As for childhood friendship, the proportion of people who experienced friendship in childhood was 76.80%. Table 1 showed the distribution of related factors in the whole and different gender. Table 1 Baseline characteristics of the participants(n = 5565) Variable All(%) Male(%) Female(%) Dependent variable CES-D-10 score < 10 3120(56.06) 1259(63.3) 1861(52.04) ≥ 10 2445(43.94) 730(36.7) 1715(47.96) Mediator Friendship No 1293(23.20) 437(21.97) 856(23.94) Yes 4272(76.80) 1552(78.03) 2720(76.06) Independent variable Childhood parental depressive symptoms No 4621(83.04) 1681(84.51) 2940(82.21) Yes 944(16.96) 308(15.49) 636(17.79) Other factors Demographic characteristic Age < 65 2764(49.67) 886(44.54) 1878(52.52) ≥ 65 2801(50.33) 1103(55.46) 1698(47.48) Gender Male 1989(35.70) 1989(100) NA Female 3576(64.30) NA 3576(100) Education Lower secondary school and above 4974(89.38) 1678(84.36) 3296(92.17) Upper secondary school and below 591(10.62) 311(15.64) 280(7.83) Marital status Married 4580(82.30) 1735(87.23) 2845(79.56) Separated, divorced, widowed 956(17.18) 227(11.41) 729(20.39) Unmarried 29(0.52) 27(1.36) 2(0.06) Related factors in childhood Childhood physical abuse No 3858(69.33) 1276(64.15) 2582(72.20) Yes 1707(30.67) 713(35.85) 994(27.80) Financial situation before 17 Worse than others 2292(41.19) 843(42.38) 1449(40.52) Same as others 2730(49.06) 974(48.97) 1756(49.11) Better than others 543(9.76) 172(8.65) 371(10.37) Others’ help before 17 Very willing 2699(48.50) 951(47.81) 1748(48.87) Somewhat willing 2174(39.07) 839(42.18) 1335(37.33) Not very willing 431(7.74) 125(6.28) 306(85.57) Not willing at all 261(4.69) 74(3.73) 187(5.23) Related factors in adulthood Alcohol use No 4543(81.64) 1184(59.53) 3359(93.93) Yes 1022(18.36) 805(40.47) 217(6.07) Combined with other diseases No 873(15.69) 316(15.89) 557(15.58) Yes 4692(84.31) 1673(84.11) 3019(84.42) Self-reported health Very good 372(6.68) 141(7.09) 231(6.46) Good 445(8.00) 165(8.30) 280(7.83) Fair 2550(45.82) 918(46.15) 1632(45.64) Poor 1668(30.00) 572(28.76) 1096(30.65) Very poor 530(9.50) 193(9.70) 337(9.42) 3.2 Association among childhood parental depression, childhood friendship and adult depressive symptoms 3.2.1 Results of logistic regression analysis We used logistic regression analysis to measure the relationship among childhood parental depression, childhood friendship and adult depressive symptoms. Before logistic regression analysis, we carried out a multicollinearity test on the factors in the related models. The result showed that there was no collinearity among the factors in logistic regression models(VIF < 10), which indicated that the analysis was feasible. We constructed three models to observe the effects of different inclusion factors on the relationship. Table 2 showed the relationship between childhood parents' depressive symptoms and adult depressive symptoms in the study population (Path C). In all models, childhood parents’ depressive symptoms was the risk factor of adult depressive symptoms (all OR > 1, P < 0.001). Table 3 showed the relationship between childhood friendship and adult depressive symptoms in the study population (Path B). In all models, childhood friendship was the protective factor of adult depressive symptoms (all OR < 1, P < 0.001). Table 4 showed the relationship between childhood parents' depressive symptoms and childhood friendship in the study population (Path A). Childhood parents' depressive symptoms was the risk factor of childhood friendship ( OR : 0.599, 95% CI : 0.511–0.702). The depressive symptoms of parents in childhood made individuals less likely to have friendships. In Table 5 , we put both childhood parents’ depressive symptoms and childhood friendship into the logistic model. Compared with that of Table 2 , the results showed that the effect of childhood parents' depressive symptoms on adult depressive symptoms was inhibited in either model ( OR : 1.917 vs 1.859, 1.725 vs 1.694, 1.621 vs 1.595). In the study population, childhood friendship played a mediating role between childhood parents' depressive symptoms and adult depressive symptoms. Table 2 Association between childhood parents’ depressive symptoms and adult depressive symptoms Variable Model 1 Model 2 Model 3 OR(95%CI) p OR(95%CI) p OR(95%CI) p Childhood parental depressive symptoms No 1.000 1.000 1.000 Yes 1.917(1.659–2.214) < 0.001 1.725(1.488–1.999) < 0.001 1.621(1.387–1.895) < 0.001 Age < 65 1.000 1.000 1.000 ≥ 65 0.808(0.721–0.906) < 0.001 0.798(0.711–0.895) < 0.001 0.723(0.640–0.817) < 0.001 Gender Male 1.000 1.000 1.000 Female 1.457(1.297–1.637) < 0.001 1.511(1.343–1.701) < 0.001 1.641(1.429–1.885) < 0.001 Education Lower secondary school and above 1.000 1.000 1.000 Upper secondary school and below 0.493(0.406–0.597) < 0.001 0.534(0.439–0.649) < 0.001 0.569(0.463–0.698) < 0.001 Marital status Married 1.000 1.000 1.000 Separated, divorced, widowed 1.370(1.181–1.590) < 0.001 1.367(1.176–1.589) < 0.001 1.348(1.150–1.581) < 0.001 Unmarried 2.458(1.144–5.284) 0.021 2.318(1.070–5.023) 0.033 2.224(0.971–5.091) 0.059 Childhood physical abuse No 1.000 1.000 Yes 1.305(1.159–1.470) < 0.001 1.216(1.073–1.378) 0.002 Financial situation before 17 Worse than others 1.000 1.000 Same as others 0.740(0.659–0.832) < 0.001 0.783(0.693–0.886) < 0.001 Better than others 0.655(0.535–0.801) < 0.001 0.727(0.587–0.899) 0.003 Others’ help before 17 Very willing 1.000 1.000 Somewhat willing 1.209(1.075–1.360) 0.002 1.168(1.031–1.322) 0.014 Not very willing 1.701(1.374–2.106) < 0.001 1.576(1.259–1.972) < 0.001 Not willing at all 1.351(1.037–1.759) 0.026 1.241(0.939–1.641) 0.130 Alcohol use No 1.000 Yes 1.188(1.006–1.402) 0.043 Combined with other diseases No 1.000 Yes 1.650(1.388–1.962) < 0.001 Self-reported health Very good 1.000 Good 1.102(0.780–1.557) 0.581 Fair 1.933(1.469–2.544) < 0.001 Poor 4.937(3.725–6.545) < 0.001 Very poor 7.900(5.694–10.960) < 0.001 Model 1 adjusted the factors related to demographic characteristics (age, sex, marriage, education level). On the basis of model 1, model 2 adjusted the depression-related factors in childhood (childhood financial situation, childhood physical abuse and childhood social support). On the basis of model 2, model 3 adjusted additional factors related to depression in adulthood (alcohol use, combined with other chronic diseases, self-reported health). Table 3 Association between childhood friendship and adult depressive symptoms Variable Model 1 Model 2 Model 3 OR(95%CI) p OR(95%CI) p OR(95%CI) p Childhood friendship No 1.000 1.000 1.000 Yes 0.711(0.625–0.808) < 0.001 0.773(0.677–0.882) < 0.001 0.788(0.685–0.906) < 0.001 Age < 65 1.000 1.000 1.000 ≥ 65 0.797(0.711–0.894) < 0.001 0.792(0.705–0.889) < 0.001 0.717(0.634–0.810) < 0.001 Gender Male 1.000 1.000 1.000 Female 1.462(1.302–1.642) < 0.001 1.521(1.352–1.711) < 0.001 1.652(1.440–1.897) < 0.001 Education Lower secondary school and above 1.000 1.000 1.000 Upper secondary school and below 0.500(0.412–0.606) < 0.001 0.542(0.446–0.660) < 0.001 0.576(0.469–0.707) < 0.001 Marital status Married 1.000 1.000 1.000 Separated, divorced, widowed 1.389(1.198–1.610) < 0.001 1.383(1.191–1.607) < 0.001 1.360(1.160–1.594) < 0.001 Unmarried 2.551(1.193–5.457) 0.016 2.352(1.093–5.064) 0.029 2.260(0.996–5.126) 0.051 Childhood physical abuse No 1.000 1.000 Yes 1.328(1.179–1.495) < 0.001 1.232(1.087–1.396) 0.001 Financial situation before 17 Worse than others 1.000 1.000 Same as others 0.708(0.631–0.795) < 0.001 0.753(0.667–0.851) < 0.001 Better than others 0.627(0.513–0.766) < 0.001 0.700(0.566–0.865) 0.001 Others’ help before 17 Very willing 1.000 1.000 Somewhat willing 1.198(1.066–1.347) 0.003 1.157(1.022–1.309) 0.021 Not very willing 1.685(1.361–2.086) < 0.001 1.556(1.242–1.948) < 0.001 Not willing at all 1.353(1.039–1.763) 0.025 1.234(0.933–1.633) 0.140 Alcohol use No 1.000 Yes 1.192(1.010–1.407) 0.038 Combined with other diseases No 1.000 Yes 1.703(1.433–2.025) < 0.001 Self-reported health Very good 1.000 Good 1.109(0.785–1.566) 0.557 Fair 1.933(1.470–2.543) < 0.001 Poor 4.924(3.716–6.525) < 0.001 Very poor 7.956(5.738–11.033) < 0.001 Model 1 adjusted the factors related to demographic characteristics (age, sex, marriage, education level). On the basis of model 1, model 2 adjusted the depression-related factors in childhood (childhood financial situation, childhood physical abuse and childhood social support). On the basis of model 2, model 3 adjusted additional factors related to depression in adulthood (alcohol use, combined with other chronic diseases, self-reported health). Table 4 Association between childhood parents’ depressive symptoms and childhood friendship Variable OR(95%CI) p Childhood parents’ depressive symptoms No 1.000 Yes 0.599(0.511–0.702) < 0.001 Childhood physical abuse No 1.000 Yes 1.158(1.007–1.332) 0.040 Financial situation before 17 Worse than others 1.000 Same as others 1.291(1.128–1.478) < 0.001 Better than others 1.873(1.445–2.428) < 0.001 Others’ help before 17 Very willing 1.000 Somewhat willing 0.826(0.718–0.952) 0.008 Not very willing 0.371(0.298–0.461) < 0.001 Not willing at all 0.294(0.225–0.383) < 0.001 Table 5 Association of childhood parents’ depressive symptoms, friendship, and adult depressive symptoms Model* Logistic analysis OR 95%CI P Model 1 Childhood parents’ depressive symptoms 1.910 1.656–2.204 < 0.001 Childhood friendship 0.724 0.638–0.821 < 0.001 Model 2 Childhood parents’ depressive symptoms 1.859 1.608–2.149 < 0.001 Childhood friendship 0.750 0.658–0.854 < 0.001 Model 3 Childhood parents’ depressive symptoms 1.694 1.460–1.964 < 0.001 Childhood friendship 0.800 0.700-0.914 0.001 Model 4 Childhood parents’ depressive symptoms 1.595 1.364–1.865 < 0.001 Childhood friendship 0.812 0.706–0.935 0.004 Model 1 only included the childhood parents’ depressive symptoms and childhood friendship. Model 2 adjusted the factors related to demographic characteristics (age, sex, marriage, education level). On the basis of model 2, model 3 adjusted the depression-related factors in childhood (childhood financial situation, childhood physical abuse and childhood social support). On the basis of model 3, model 4 adjusted additional factors related to depression in adulthood (alcohol use, combined with other chronic diseases, self-reported health). 3.2.2 Results of Sobel-Goodman mediation test We also used Sobel-Goodman mediation test to study whether childhood friendship was the mediator between childhood parental depressive symptoms and adult depressive symptoms. Table 6 showed the results of test. Through the test, we found that childhood friendship did play an mediating role between the other two, and this indirect effect accounted for 6.14% of the total effect ( p < 0.001). Sobel-Goodman mediation test supported the results of the previous logistic regression analysis. Table 6 Mediation of childhood friendship in the association between childhood parental depressive symptoms and adult depression symptoms Mediation of childhood friendship a Association of childhood parental depressive symptoms and adult depression symptoms Effect Coefficient Z P Indirect 0.01 4.37 < 0.001 Direct 0.16 9.03 0 Total 0.17 9.67 0 Proportion of total effect that is mediated % 6.14 a The Sobel-Goodman test found childhood friendship was a mediator in the association of childhood parental depression with adult depressive symptoms, with a z value of 4.37( P <0.001). 4. DISCUSSION 4.1 The present situation of depressive symptoms in study population We selected 5565 participants with CVD who participated in the 2018 wave of the CHARLS national baseline survey as the study population. Among them, the population with significant depressive symptoms accounted for 43.94%, which was higher than that of the total population in the 2018 CHARLS survey. It shows that people who suffer from CVD are at high risk of adult depressive symptoms. This is consistent with the findings of other studies [25, 43] . CVD and depression are both diseases with high incidence worldwide [24] . Many studies have found that there were a certain relationship between the two diseases [22, 23] . Compared with that of the general population, patients with depression have a higher risk of CVD [8, 44] , and patients with CVD have a higher risk of depression [21, 25] . There is a tendency of co-disease between the two [21, 22] . And people who suffer from both depression and CVD have poorer treatment and more severe symptoms than that of others [45] . Patients with specific diseases have a higher risk of depressive symptoms than patients in general [5] . Related studies have pointed out that this is partly due to the impact of the disease burden on patients [5, 8] . Therefore, patients with related diseases are often at high risk of developing depressive symptoms. The risk of developing depressive symptoms in other types of diseases is also worth exploring. Among them, patients with CVD are relatively special. Because the development of the disease is more likely to be affected by depressive symptoms than the other diseases [8] . Overall, people suffering from CVD should be the focus of our attention in the study of depression. 4.2 The mediating effect of childhood friendship between childhood parental depressive symptoms and adult depressive symptoms In patients with CVD, existing studies often focused on the effect of disease development on the depressive symptoms. Few studies have explored the effect of childhood-related factors. In our study, we found that individuals who had been exposed to depressed parents in childhood had a higher risk of developing depressive symptoms in adulthood than that of those who did not. It is consistent with the results of many studies on depressive symptoms between parents and children [46–48] . In addition to the genetic predisposition to depression, offspring may also be influenced by parents who suffered from depression because of a negative living environment provided by depressed parents [9] . In most families, individuals must live with their parents for a long time before reaching adulthood. Children's mental health is mainly influenced by family factors and external environmental factors. Parents suffering from depression can hardly provide a stable, positive and healthy life for their offspring, and the frequency of negative childhood events will be higher [14, 15] . These are the risk factors of adult depressive symptoms [14] . We also found that in childhood, individuals who had experienced friendship had a lower risk of adult depressive symptoms than that of those who had not. In other studies of depressive symptoms, friendship is also one of several protective factors that are often studied [40] . In childhood, friends and parents are the objects of long-term contact. Getting along well with each other is beneficial to the development of children's mental health. The existence of friendship depends on individual cognition. If a person thinks that he had a good time with his friends, it shows that there is a positive emotional memory (friendship) in his cognitive range. It partly explains why friendship is a protective factor for depression. Although parental depressive symptoms and friendship are common influencing factors of adult depressive symptoms, there are few studies to analyze whether there is a certain relationship between the three. Moreover, in the study of mediators between parental and offspring depression, there are more negative mediating factors [10, 27] . In fact, reducing the emergence of risk factors and promoting the occurrence of protective factors are equally important for disease prevention. Our study shows that childhood friendship is a protective mediator between childhood parental depressive symptoms and adult depressive symptoms, and this mediating effect accounts for 6.14% of the total effect. It suggests that childhood parental depression can ultimately affect the occurrence of adult depressive symptoms by affecting childhood friendship. From a psychological point of view, individuals who have experienced negative psychological events may be more eager for a stable and positive emotional experience. Similarly, children who have long-term contact with depressed parents are more eager for emotional support than their peers. Reliable elders and friendly peers are good choices. Good friendship may effectively reduce the risk of adult depressive symptoms of individuals exposed to parental depressive symptoms. Our results also suggest that friendship can be used as an intervention for depression, especially for those who contact depressed parents. Some studies have taken the cultivation and promotion of friendship as an intervention for some diseases [49, 50] . We can also consider preventing depression by promoting the development of individual friendship. From the point of view of life course epidemiology, the occurrence of diseases is the result of the joint action of all the risk factors that individuals come into contact with in their life course [6] . There is a certain relationship between depressive symptoms and related emotional events in early life [14] . However, these studies are usually carried out in the general population. Our study found that childhood-related events were still associated with adult depressive symptoms in patients with CVD. Compared with that of the general population, the situation of patients with CVD is relatively more complex. In addition to the effects of common life events, the pain caused by disease also continues to affect the patients. If the patients develop depressive symptoms at the same time, the two diseases will affect each other, leading to a worsening condition. Therefore, patients with CVD need to be more alert to the occurrence of depressive symptoms. Whether in patients with CVD or in the general population, childhood-related events may affect adult depressive symptoms. The results of this study can be deduced to people with other diseases or the general population. In the aspect of preventing depression, we should also consider the influence of individual's early life experience. At the same time, we should pay more attention to the high-risk groups of depression, such as children exposed to depressed parents. For children with depressed parents, it is difficult to separate parents from children. However, we can actively carry out depression surveys for adolescents to ensure that these high-risk groups will be identified as soon as possible. Then, schools or health institutions can organize relevant activities to promote the friendly relationship between these groups and their peers. In a word, early intervention to high-risk groups can effectively prevent the occurrence of depression. 4.3 Limitations In our study, the population with CVD was identified by patients' self-reports. In other words, participants confirm current disease state by recalling whether they have been diagnosed with hypertension or heart disease by doctors. There is a drawback to this way of judgment. People who suffer from diseases but seldom go to hospitals for economic or other reasons are ignored. At the same time, self-reporting is less sensitive and specific than some techniques that identify diseases through tests. The depressive symptoms of parents in individual’s childhood is also obtained through participants’ recollection. First of all, this will lead to the existence of a recall bias. According to the criteria of International Classification of Diseases-10(ICD-10), the judgment of depression depends on the typical symptoms and common symptoms of individuals. However, the specific symptoms related to parental depressive symptoms in childhood have been difficult to obtain. It's not just because it's an early event in life. In the age of the participants' parents, the medical service system is not perfect. At the same time, individuals are ashamed to conduct mental tests. It was difficult to obtain the medical reports of the participants' parents at that time. This information is available only through the patient's recollection. This can lead a certain impact to the study. In the 2018 wave of CHARLS national baseline Survey, CES-D 10 was used to measure depression in the study population. We used 10 points as a cut-off value of the scale to determine whether individuals had significant depressive symptoms. However, CES-D10 is more suitable for evaluating the severity of depressive symptoms than as a diagnostic screening tool. One study found that this screening method was less specific when using 8 and 10 as cutoff values to measure the sensitivity and specificity of the CES-D 10 tool for the diagnosis of depression [51] . It suggests that individuals who do not suffer from depression may be misjudged to be depressed. 5. CONCLUSION People with CVD is a high-risk group suffering from depression. Among middle-aged and elderly people with CVD in China, childhood parental depression can increase the risk of adult depressive symptoms. On the contrary, childhood friendship is the protective factor of adult depressive symptoms. In addition, childhood friendship is the mediating factor between childhood parental depression and adult depressive symptoms. It suggests that we can consider cultivating and promoting friendship as an intervention measure for depression in the group that exposed to depressed parents in childhood. Declarations CONFLICT OF INTERESTS None declared. FUNDING This study was sponsored by Special Project of Hospital Development Research Center of Chengdu Medical College (Grant number: YYFZ21008). Author Contribution RY.Y. and XJ.Y. conceived the study. The manuscript of this article was drafted by RY.Y. and XJ.Y. RY.Y., H.X. and HX.C. designed the writing strategies RY.Y., HX.C. and H.X. were involved in the statistical strategy for data analysis. All authors read and approved the final version of this article. ACKNOWLEDGMENTS Our study is a secondary data analysis based on the public data of the China Health and Retirement Longitudinal Study(CHARLS). Thanks to Peking University for publishing CHARLS data for our research and analysis. 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Beyond Social Skills: Supporting Peer Relationships and Friendships for School-Aged Children with Autism Spectrum Disorder. Semin Speech Lang 2018; 39 : 178 − 94. Björgvinsson T, Kertz SJ, Bigda-Peyton JS, McCoy KL, Aderka IM. Psychometric properties of the CES-D-10 in a psychiatric sample. Assessment 2013; 20 : 429 − 36. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4548466","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":323711709,"identity":"4dca21ac-114e-448f-aba8-cc6deb508fb4","order_by":0,"name":"Ruoyun Yin","email":"","orcid":"","institution":"Chengdu Seventh People's Hospital / Chengdu Cancer Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ruoyun","middleName":"","lastName":"Yin","suffix":""},{"id":323711710,"identity":"aefc5fb9-7cd1-4c3d-ab22-2d080cec37ca","order_by":1,"name":"Hongxia Cai","email":"","orcid":"","institution":"Chengdu Seventh People's Hospital / Chengdu Cancer Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hongxia","middleName":"","lastName":"Cai","suffix":""},{"id":323711711,"identity":"b1d22f14-6b79-4336-8a7d-7079ad623d33","order_by":2,"name":"Huan Xiong","email":"","orcid":"","institution":"Chengdu Seventh People's Hospital / Chengdu Cancer Hospital","correspondingAuthor":false,"prefix":"","firstName":"Huan","middleName":"","lastName":"Xiong","suffix":""},{"id":323711712,"identity":"6e38cfcc-7caf-419d-a712-47cab2148999","order_by":3,"name":"Xiujuan Yang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA00lEQVRIiWNgGAWjYHCCBAYehv8MDOyNjQ8/kKCFmYGB53CzsQTR9oC1SKS3CfAQo9rgRsLDD2/+sCVuuPmwjUGCwU5Ot4GQljMHkiXntvEkbrid2PaggCHZ2OwAIS3HG9KYeRskQFraDSQYDiRuI6jlMEMaM88fA6DDDrZJ8BClBWQLD1tC4oYbjERqkYT45YDxzDOJwEA2IMIvfDdyEoEhdkC27/jxhw8/VNjJEdSicIAnAUQ7LgCrNCCgHATkG9jBau3lG4hQPQpGwSgYBSMTAABPX0xOZJuYKgAAAABJRU5ErkJggg==","orcid":"","institution":"Chengdu Seventh People's Hospital / Chengdu Cancer Hospital","correspondingAuthor":true,"prefix":"","firstName":"Xiujuan","middleName":"","lastName":"Yang","suffix":""}],"badges":[],"createdAt":"2024-06-08 01:53:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4548466/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4548466/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60598062,"identity":"34cdf081-2f2a-4357-b7cc-3c7bc33cf422","added_by":"auto","created_at":"2024-07-18 15:52:52","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":353900,"visible":true,"origin":"","legend":"\u003cp\u003eFlow chart of sample selection.\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4548466/v1/ff0b62102ba5bdcd55bdf127.jpg"},{"id":60598061,"identity":"f2454eec-1303-4505-9a26-15785761f7ad","added_by":"auto","created_at":"2024-07-18 15:52:52","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":148704,"visible":true,"origin":"","legend":"\u003cp\u003eConceptual Model\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4548466/v1/d02bd7f4cf6bac5437e97374.jpg"},{"id":64763653,"identity":"d59d9317-0ee1-4ce7-8bc9-eed56492e2ad","added_by":"auto","created_at":"2024-09-18 13:29:40","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1809763,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4548466/v1/48908978-d298-4d75-9831-f676ec6fee20.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Protective Role of Childhood Friendship on the Effects of Parental Depressive Symptoms and Adult Depressive Symptoms among People with Cardiovascular Disease","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eDepression is one of the diseases with the highest prevalence in the global population, which has caused great disease burden. World Health Organization predicted that major depression would become the primary cause of global disease burden by 2030\u003csup\u003e[1]\u003c/sup\u003e. According to a global disease survey in 2016, more than 34\u0026nbsp;million all-age disability-adjusted life-years (DALYs) could be attributed to depression\u003csup\u003e[2]\u003c/sup\u003e. Compared with that of the world level, the present situation of depression in China is also severe. A meta-analysis showed that the prevalence of depression among Chinese children and adolescents in different regions was about 20%\u003csup\u003e[3]\u003c/sup\u003e. And the result of a survey on depression among the elderly in China found that the depression prevalence among the study population was 38.5%\u003csup\u003e[4]\u003c/sup\u003e. It shows that the prevalence of depression is high in different Chinese populations. So, it is of great practical significance to study the prevention of depression.\u003c/p\u003e \u003cp\u003eIn order to prevent the occurrence of depressive symptoms more specifically, it is important to understand the occurrence and development of depressive symptoms and to identify the relevant influencing factors during this period\u003csup\u003e[5]\u003c/sup\u003e. It needs to be clear that the occurrence of depressive symptoms is the accumulation of related events in the whole life cycle\u003csup\u003e[6]\u003c/sup\u003e. Experiences in childhood and adulthood could affect the development of later depressive symptoms\u003csup\u003e[5, 7]\u003c/sup\u003e. At present, relevant studies often focused on the influencing factors of adulthood. For the general population, researchers often consider the effects of life events in adulthood on depressive symptoms including stress, burnout et al.\u003csup\u003e[5]\u003c/sup\u003e. For people with disease, the disease condition, medication and life quality are the focus of attention\u003csup\u003e[5, 8]\u003c/sup\u003e, while the Experiences in childhood are less studied. However, childhood is a critical period for the health development of individual psychology. Related studies have found that childhood life events contributed to adult depressive symptoms\u003csup\u003e[9]\u003c/sup\u003e. The mental state of long-term contact objects in childhood also affected the occurrence and development of individual depression symptoms\u003csup\u003e[10]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eFor children, parents might be the people with the highest contact frequency. Parents with depressive symptoms might influence their children in many ways. From the perspective of psychiatry, some mental diseases, such as depression, schizophrenia, anxiety, have certain genetic tendencies\u003csup\u003e[11\u0026ndash;13]\u003c/sup\u003e. From a psychological point of view, people are more susceptible to their parents' influence in childhood. Individual behaviors and thoughts reflected in adulthood have something in common with their parents to a certain extent. When parents existed mental problems, it meaned that they might have difficulties on taking care of their children, such as lower enthusiasm, over-participation, disgust, abuse and over-supervision\u003csup\u003e[14\u0026ndash;16]\u003c/sup\u003e. These may directly or indirectly affect the mental health of their children in adulthood. Based on lifelong epidemiological studies, parents with depressive symptoms might have poor financial conditions and living habits, and they shared such a living environment with their offspring. All of these factors might be associated with adult depression\u003csup\u003e[7, 17]\u003c/sup\u003e. Related study showed that the people contacting with parents with depressive symptoms in childhood had a higher risk of adult depressive symptoms than the non-contacts\u003csup\u003e[17]\u003c/sup\u003e. Many studies supported this conclusion\u003csup\u003e[18, 19]\u003c/sup\u003e. In addition, parents' depressive symptoms in individuals\u0026rsquo; childhood not only increases the risk of adult depressive symptoms in offspring, but also makes the individual's treatment effect on depressive symptoms worse\u003csup\u003e[20]\u003c/sup\u003e. Overall, childhood parental depressive symptoms is a relatively clear risk factor for adult depressive symptoms.\u003c/p\u003e \u003cp\u003e However, there are still some points to discuss about the childhood parents' depressive symptoms and individual adult depressive symptoms. Firstly, what are the factors that may moderate or mediate between the two? Secondly, whether parents' depressive symptoms in childhood are still the influencing factors of adult depressive symptoms after adjusting the relevant factors in adulthood? Thirdly, the existing studies tend to focus on the general population, specific age groups (children, adolescents, the elderly) and people with chronic diseases. In certain disease groups, is childhood parental depressive symptoms still a risk factor for adult depressive symptoms?\u003c/p\u003e \u003cp\u003ePeople with cardiovascular diseases(CVD) are a high-risk group suffering from depression. Moreover, depressive symptoms and CVD often coexist\u003csup\u003e[21\u0026ndash;23]\u003c/sup\u003e. Studies have shown that the prevalence of CVD in different groups was from 20\u0026ndash;45%, which is higher than that of the general population of the same age\u003csup\u003e[24]\u003c/sup\u003e. In patients with some kinds of heart diseases, depressive symptoms is even more serious. Related study found that 71.4% of women and 60.4% of men had symptoms of depression or anxiety in people with myocardial infarction(MI)\u003csup\u003e[25]\u003c/sup\u003e. However, it is different from the general population. The studies on depressive symptoms in patients with CVD often focus on the related factors after the occurrence of the disease\u003csup\u003e[8]\u003c/sup\u003e. At present, there is few studies exploring on the influence of childhood-related factors on adult depressive symptoms in patients with CVD.\u003c/p\u003e \u003cp\u003eWe want to explore a protective mediator between childhood parental depressive symptoms and depressive symptoms in adulthood. However, in recent years, studies are more likely to consider some risk factors as mediator s, such as rumination, emotion regulation and negative life events\u003csup\u003e[10, 26, 27]\u003c/sup\u003e. In fact, protective and risk factors are equally important. In some depression-related studies on the mediating role, friendship is often regarded as a protective mediator. A longitudinal survey on child abuse and neglect found that depression and friendship were related to suicidal ideation in late adolescence, and friendship was the protective factor of the other two\u003csup\u003e[28]\u003c/sup\u003e. The result of an adolescent study showed that adolescent friendship /family support mediated between boys' and girls' early life stress and late adolescent depressive symptoms\u003csup\u003e[29]\u003c/sup\u003e. Therefore, friendship might also be a mediator between childhood parents' depressive symptoms and offspring's depressive symptoms in adulthood. The purpose of our study is to clarify the possible relationship among childhood parents' depressive symptoms, friendship and adult depressive symptoms.\u003c/p\u003e"},{"header":"2. METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Participants\u003c/h2\u003e \u003cp\u003eBased on the published data of the China Health and Retirement Longitudinal Study(CHARLS) conducted by Peking University, we studied the relationship among childhood parental depressive symptoms, childhood friendship and adult depressive symptoms among people over 45 years old with CVD. CHARLS is the first nationally representative cohort study for the middle-aged and elderly Chinese population. Since the first national baseline survey in 2011, CHARLS has followed up the previous survey population every 2\u0026ndash;3 years. So far, CHARLS has conducted four national baseline surveys in 28 provinces, 150 regions and 450 villages/communities in China\u003csup\u003e[30]\u003c/sup\u003e. CHARLS released the latest 2018 wave of the national baseline survey data in 2020. CHARLS life course survey is a life history research in 2014, aiming at collecting the data of the past educational experience, family, economy and health of the study population. This study used the data from both the life history survey and the 2018 wave of CHARLS national baseline survey.\u003c/p\u003e \u003cp\u003e A total of 8971 people with CVD participated in the CHARLS national baseline survey in 2018. After excluding the individuals who had incomplete part of the Center for Epidemiologic Studies Depression Scale (CES-D, n\u0026thinsp;=\u0026thinsp;670) or missing baseline characteristic data(n\u0026thinsp;=\u0026thinsp;1730), there were 6571 people left. Among them, a total of 5565 people who participated in the life course survey and had complete needed data were included in our study (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Our study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline\u003csup\u003e[31]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Measures\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1 Cardiovascular disease\u003c/h2\u003e \u003cp\u003eThe information on the disease part is collected through the participants\u0026rsquo; self-report. In the survey, the questions related to the condition of CVD included the following two: Have you been diagnosed with hypertension(question 1)/heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems(question 2) by a doctor? In our study, participants who answered \"yes\" to any of these questions were judged to have CVD. Some related studies have adopted similar judgment methods \u003csup\u003e[32, 33]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2 Parental depressive symptoms\u003c/h2\u003e \u003cp\u003eIn the life course survey, CHARLS collected information about the mental state of the participants' parents during participants' childhood(before the age of 17). This part of the survey mainly includes two aspects: ①whether the parents had depressive symptoms in the interviewees\u0026rsquo; childhood: During the years you were growing up, had your male/female guardian showed continued signs of sadness or depression that lasted 2 weeks or more?; ②persistent frequency of depressive symptoms: Was this problem of your male/female guardian, sadness or depression during all, most, some, or only a little of your childhood? According to the standard of International Classification of Diseases-10 (ICD-10), depression can be judged if symptoms such as upset, loss of interest and pleasure, lack of energy or fatigue and other common symptoms of depression persist for more than two weeks. Many studies have used ICD-10 as a criterion for judging depression\u003csup\u003e[34, 35]\u003c/sup\u003e. In CHARLS life course survey, information about parents' mental condition was collected through participants' recollection. Many specific symptoms related to depression of parents during participants' childhood have been difficult to obtain. So, after considering the actual situation and ICD-10 diagnostic principles, we judged the parent who had sad or depressed symptoms most of the time in participant\u0026rsquo; childhood as suffering from depression.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.2.3 Adult Depression Symptom\u003c/h2\u003e \u003cp\u003e10-item Center for Epidemiologic Studies Depression Scale(CES-D 10)was used to investigate the depression of the study population. CES-D 10 is a simplified version based on CES-D 20\u003csup\u003e[36]\u003c/sup\u003e, which is suitable for screening depression symptoms of the elderly\u003csup\u003e[37, 38]\u003c/sup\u003e. The scale mainly includes 10 items related to emotional symptoms, with scores ranging from 0 to 30. Previous studies have identified people who scored more than 10 in the CES-D 10 as having significant depressive symptoms\u003csup\u003e[39]\u003c/sup\u003e. Our study chose the same method of judgment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.2.4 Childhood friendship\u003c/h2\u003e \u003cp\u003eFriendship is a psychological concept, which refers to maintaining a relaxed and harmonious relationship with friends. Therefore, some studies regard \"whether to have friends\" or \"whether to have a happy memory with friends\" as the criterion for judging friendship\u003csup\u003e[40]\u003c/sup\u003e. In the investigation of childhood friendship, participants were asked \u0026ldquo;When you were a child, did you often have a group of friends that you felt comfortable spending time with? Is it often, sometimes, not very often or never?\u0026rdquo;. We judged individuals who often/sometimes played with friends as having friendship in childhood.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.2.5 Control variables in the baseline survey\u003c/h2\u003e \u003cp\u003eIn order to control the possible influence of other depression-related factors on the analysis, it is necessary to include the adjusting factors. It was mainly divided into three categories: baseline characteristics, depression-related factors in childhood and adulthood. The baseline characteristic data of gender, age, education level and marital status were collected through participants' self-reports, and secondly confirmed by using the relevant documents. Age was divided into two categories, bounded by 65. Participants' marital status was divided into married, unmarried, and others (separation, divorce, and widowhood). The education level was divided into two categories: \u0026rdquo;lower secondary school and above\u0026rdquo; and \u0026ldquo;upper secondary school and below\u0026rdquo;. Some studies based on CHARLS data adopted the same division method\u003csup\u003e[4, 41]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe depression-related factors in childhood included childhood family economic status, physical abuse and social support. The economic level of childhood was determined by comparing with the economic situation of the surrounding people in the same period. In early China, this way of judging economic level had more reference value than judging by amount, and the recall bias was smaller. Childhood financial situations(before the age of 17) were classified into \u0026ldquo;worse than others\u0026rdquo;, \u0026ldquo;same as others\u0026rdquo; and \u0026ldquo;better than others\u0026rdquo;. Some studies used the same classification method\u003csup\u003e[4]\u003c/sup\u003e. Using the Adverse Childhood Experience-International Questionnaire (ACE-IQ) as a reference\u003csup\u003e[42]\u003c/sup\u003e, we judged physical abuse. Physical abuse was determined as long as the participant was beaten in childhood by either of the male guardian/female guardian/siblings at a certain frequency(often, sometimes). The help willingness of people around participants in childhood reflected the social support they received to some extent. Childhood physical abuse, financial condition and social support are common influencing factors of depressive symptoms\u003csup\u003e[5]\u003c/sup\u003e. The depression-related factors in adulthood included alcohol use, combined with other chronic diseases, and self-reported health. Drinking was a two-category variable, which was determined according to whether there was drinking behavior more than once a month in the past 12 months. In CVD patients, disease condition and self-reported health were related factors of depressive symptoms.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Statistical analysis\u003c/h2\u003e \u003cp\u003eSubsequent analysis included descriptive statistics of related factors, logistic regression analysis to examine mediation effect and Sobel-Goodman mediation test. In the descriptive statistics section, mean(M) and standard deviation(SD) were used to describe the distribution of continuous variables such as age and CES-D 10 scores in the study population. In order to facilitate the later analysis, all the factors involved in the study were set as classified variables. We calculated the distribution of various factors in terms of population and gender, and presented them in the form of a table.\u003c/p\u003e \u003cp\u003eNext, we analyzed the relationship among childhood parental depressive symptoms, childhood friendship and adult depression symptoms. We assumed that childhood friendship was a mediator between childhood parental depression and adult depressive symptoms. The relationship among them was shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e: Path A: childhood parental depression can influence childhood friendship; Path B: childhood friendship can influence adult depressive symptoms; Path C: childhood parental depression can influence adult depressive symptoms. All the following analyses were based on this assumption. According to Baron and Kenny's method, childhood friendship is the mediator between childhood parents' depressive symptoms and adult parents' depressive symptoms based on establishment of the above three paths. When the relationship between parental depressive symptoms and childhood friendship is relatively stable, childhood friendship might be considered as a mediator rather than a moderator. If the above hypothesis is not established, the childhood friendship will be verified again as a moderator.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eBefore the logistic regression analysis, we carried out the multi-collinearity analysis to ensure that there was no collinearity among the factors included in the models. The specific steps of the analysis were as follows: 1) to analyze the relationship between childhood parents' depressive symptoms and adult depressive symptoms; 2) to analyze the relationship between childhood friendship and adult depressive symptoms; 3) to analyze the relationship between childhood parents' depressive symptoms and childhood friendship; 4) to analyze the relationship between childhood parents' depressive symptoms, childhood friendship and adult depressive symptoms. Multi-level logistic regression was applied to each step of the above analysis. By comparing the changes of \u003cem\u003eOR\u003c/em\u003e (95%\u003cem\u003eCI\u003c/em\u003e) among the models with different factors, the actual role of related factors in the model was determined. Meanwhile, we used Sobel-Goodman mediation test to measure the mediating effect of childhood friendship. The odds ratio (\u003cem\u003eOR\u003c/em\u003e) and 95% confidence interval (95%\u003cem\u003eCI\u003c/em\u003e) were reported in correlation analysis. Two-tailed \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 showed there was statistical significance. SPSS 20.0 and STATA 15.0 were used for statistical analysis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Ethics approvals\u003c/h2\u003e \u003cp\u003e Before conducting each investigation of CHARLS, it was approved by the Institutional Review Board at Peking University. The major household surveys involved in CHARLS were approved by the Institutional Review Board(IRB) with the number of IRB00001052-11015. All researches were conducted with the knowledge of the respondents. Participants who have signed informed consent could be included in CHARLS.\u003c/p\u003e \u003cp\u003eOur study is a secondary data analysis that is based on CHARLS data shared by Peking University on a public platform. According to relative regulations, secondary analysis based on public data is not subject to ethical approval or informed consent. Our study has been performed in accordance with the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. RESULTS","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Participants\u0026rsquo; characteristics in study\u003c/h2\u003e \u003cp\u003eWe conducted a study on the population over 45 years old with CVD in China. After screening, a total of 5565 eligible participants were included in our study. Among them, the male accounted for 35.70% of the study population. The mean(standard deviation, SD) age of the population was 64.33(9.67). In the part of CES-D 10 survey, the mean (SD) score was 9.64(6.91), and 43.94% scored 10 points or more. In the 2018 wave of CHARLS national baseline survey, compared with that in the total population (36.62%), the population with CVD (43.94%) had a higher proportion of significant depressive symptoms (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05). With regard to the participants' childhood survey, the results showed that 16.96% participants\u0026rsquo; parents existed the depressive symptoms during participants\u0026rsquo; childhood. As for childhood friendship, the proportion of people who experienced friendship in childhood was 76.80%. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e showed the distribution of related factors in the whole and different gender.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics of the participants(n\u0026thinsp;=\u0026thinsp;5565)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAll(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMale(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDependent variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCES-D-10 score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3120(56.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1259(63.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1861(52.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2445(43.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e730(36.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1715(47.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMediator\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriendship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1293(23.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e437(21.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e856(23.94)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4272(76.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1552(78.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2720(76.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIndependent variable\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood parental depressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4621(83.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1681(84.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2940(82.21)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e944(16.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e308(15.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e636(17.79)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOther factors\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDemographic characteristic\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2764(49.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e886(44.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1878(52.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2801(50.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1103(55.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1698(47.48)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1989(35.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1989(100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3576(64.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3576(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower secondary school and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4974(89.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1678(84.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3296(92.17)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper secondary school and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e591(10.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e311(15.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e280(7.83)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4580(82.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1735(87.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2845(79.56)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated, divorced, widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e956(17.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e227(11.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e729(20.39)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29(0.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(1.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(0.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelated factors in childhood\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood physical abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3858(69.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1276(64.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2582(72.20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1707(30.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e713(35.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e994(27.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinancial situation before 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorse than others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2292(41.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e843(42.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1449(40.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSame as others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2730(49.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e974(48.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1756(49.11)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBetter than others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e543(9.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e172(8.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e371(10.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u0026rsquo; help before 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2699(48.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e951(47.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1748(48.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomewhat willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2174(39.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e839(42.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1335(37.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot very willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e431(7.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e125(6.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e306(85.57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot willing at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e261(4.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74(3.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e187(5.23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelated factors in adulthood\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4543(81.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1184(59.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3359(93.93)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1022(18.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e805(40.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e217(6.07)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCombined with other diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e873(15.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e316(15.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e557(15.58)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4692(84.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1673(84.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3019(84.42)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-reported health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e372(6.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e141(7.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e231(6.46)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e445(8.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e165(8.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e280(7.83)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2550(45.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e918(46.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1632(45.64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1668(30.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e572(28.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1096(30.65)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e530(9.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e193(9.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e337(9.42)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Association among childhood parental depression, childhood friendship and adult depressive symptoms\u003c/h2\u003e \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e \u003ch2\u003e3.2.1 Results of logistic regression analysis\u003c/h2\u003e \u003cp\u003eWe used logistic regression analysis to measure the relationship among childhood parental depression, childhood friendship and adult depressive symptoms. Before logistic regression analysis, we carried out a multicollinearity test on the factors in the related models. The result showed that there was no collinearity among the factors in logistic regression models(VIF\u0026thinsp;\u0026lt;\u0026thinsp;10), which indicated that the analysis was feasible.\u003c/p\u003e \u003cp\u003eWe constructed three models to observe the effects of different inclusion factors on the relationship. Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e showed the relationship between childhood parents' depressive symptoms and adult depressive symptoms in the study population (Path C). In all models, childhood parents\u0026rsquo; depressive symptoms was the risk factor of adult depressive symptoms (all \u003cem\u003eOR\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;1, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e showed the relationship between childhood friendship and adult depressive symptoms in the study population (Path B). In all models, childhood friendship was the protective factor of adult depressive symptoms (all \u003cem\u003eOR\u0026thinsp;\u0026lt;\u003c/em\u003e\u0026thinsp;1, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e showed the relationship between childhood parents' depressive symptoms and childhood friendship in the study population (Path A). Childhood parents' depressive symptoms was the risk factor of childhood friendship (\u003cem\u003eOR\u003c/em\u003e: 0.599, 95%\u003cem\u003eCI\u003c/em\u003e: 0.511\u0026ndash;0.702). The depressive symptoms of parents in childhood made individuals less likely to have friendships. In Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, we put both childhood parents\u0026rsquo; depressive symptoms and childhood friendship into the logistic model. Compared with that of Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the results showed that the effect of childhood parents' depressive symptoms on adult depressive symptoms was inhibited in either model (\u003cem\u003eOR\u003c/em\u003e: 1.917 vs 1.859, 1.725 vs 1.694, 1.621 vs 1.595). In the study population, childhood friendship played a mediating role between childhood parents' depressive symptoms and adult depressive symptoms.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between childhood parents\u0026rsquo; depressive symptoms and adult depressive symptoms\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eModel 3\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood parental depressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.917(1.659\u0026ndash;2.214)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.725(1.488\u0026ndash;1.999)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.621(1.387\u0026ndash;1.895)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.808(0.721\u0026ndash;0.906)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.798(0.711\u0026ndash;0.895)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.723(0.640\u0026ndash;0.817)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.457(1.297\u0026ndash;1.637)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.511(1.343\u0026ndash;1.701)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.641(1.429\u0026ndash;1.885)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower secondary school and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper secondary school and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.493(0.406\u0026ndash;0.597)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.534(0.439\u0026ndash;0.649)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.569(0.463\u0026ndash;0.698)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated, divorced, widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.370(1.181\u0026ndash;1.590)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.367(1.176\u0026ndash;1.589)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.348(1.150\u0026ndash;1.581)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.458(1.144\u0026ndash;5.284)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.318(1.070\u0026ndash;5.023)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.224(0.971\u0026ndash;5.091)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood physical abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.305(1.159\u0026ndash;1.470)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.216(1.073\u0026ndash;1.378)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinancial situation before 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorse than others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSame as others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.740(0.659\u0026ndash;0.832)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.783(0.693\u0026ndash;0.886)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBetter than others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.655(0.535\u0026ndash;0.801)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.727(0.587\u0026ndash;0.899)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u0026rsquo; help before 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomewhat willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.209(1.075\u0026ndash;1.360)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.168(1.031\u0026ndash;1.322)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot very willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.701(1.374\u0026ndash;2.106)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.576(1.259\u0026ndash;1.972)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot willing at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.351(1.037\u0026ndash;1.759)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.241(0.939\u0026ndash;1.641)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.130\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.188(1.006\u0026ndash;1.402)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.043\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCombined with other diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.650(1.388\u0026ndash;1.962)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-reported health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.102(0.780\u0026ndash;1.557)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.581\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.933(1.469\u0026ndash;2.544)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.937(3.725\u0026ndash;6.545)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.900(5.694\u0026ndash;10.960)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eModel 1 adjusted the factors related to demographic characteristics (age, sex, marriage, education level). On the basis of model 1, model 2 adjusted the depression-related factors in childhood (childhood financial situation, childhood physical abuse and childhood social support). On the basis of model 2, model 3 adjusted additional factors related to depression in adulthood (alcohol use, combined with other chronic diseases, self-reported health).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between childhood friendship and adult depressive symptoms\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eModel 3\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood friendship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.711(0.625\u0026ndash;0.808)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.773(0.677\u0026ndash;0.882)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.788(0.685\u0026ndash;0.906)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.797(0.711\u0026ndash;0.894)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.792(0.705\u0026ndash;0.889)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.717(0.634\u0026ndash;0.810)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.462(1.302\u0026ndash;1.642)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.521(1.352\u0026ndash;1.711)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.652(1.440\u0026ndash;1.897)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower secondary school and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper secondary school and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.500(0.412\u0026ndash;0.606)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.542(0.446\u0026ndash;0.660)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.576(0.469\u0026ndash;0.707)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeparated, divorced, widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.389(1.198\u0026ndash;1.610)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.383(1.191\u0026ndash;1.607)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.360(1.160\u0026ndash;1.594)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.551(1.193\u0026ndash;5.457)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.352(1.093\u0026ndash;5.064)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.260(0.996\u0026ndash;5.126)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood physical abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.328(1.179\u0026ndash;1.495)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.232(1.087\u0026ndash;1.396)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinancial situation before 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorse than others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSame as others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.708(0.631\u0026ndash;0.795)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.753(0.667\u0026ndash;0.851)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBetter than others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.627(0.513\u0026ndash;0.766)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.700(0.566\u0026ndash;0.865)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u0026rsquo; help before 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomewhat willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.198(1.066\u0026ndash;1.347)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.157(1.022\u0026ndash;1.309)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot very willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.685(1.361\u0026ndash;2.086)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.556(1.242\u0026ndash;1.948)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot willing at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.353(1.039\u0026ndash;1.763)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.234(0.933\u0026ndash;1.633)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.140\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.192(1.010\u0026ndash;1.407)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCombined with other diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.703(1.433\u0026ndash;2.025)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-reported health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.109(0.785\u0026ndash;1.566)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.557\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.933(1.470\u0026ndash;2.543)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.924(3.716\u0026ndash;6.525)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.956(5.738\u0026ndash;11.033)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eModel 1 adjusted the factors related to demographic characteristics (age, sex, marriage, education level). On the basis of model 1, model 2 adjusted the depression-related factors in childhood (childhood financial situation, childhood physical abuse and childhood social support). On the basis of model 2, model 3 adjusted additional factors related to depression in adulthood (alcohol use, combined with other chronic diseases, self-reported health).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between childhood parents\u0026rsquo; depressive symptoms and childhood friendship\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood parents\u0026rsquo; depressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.599(0.511\u0026ndash;0.702)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood physical abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.158(1.007\u0026ndash;1.332)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinancial situation before 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorse than others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSame as others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.291(1.128\u0026ndash;1.478)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBetter than others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.873(1.445\u0026ndash;2.428)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u0026rsquo; help before 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomewhat willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.826(0.718\u0026ndash;0.952)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot very willing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.371(0.298\u0026ndash;0.461)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot willing at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.294(0.225\u0026ndash;0.383)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation of childhood parents\u0026rsquo; depressive symptoms, friendship, and adult depressive symptoms\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eModel*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eLogistic analysis\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eOR\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e95%CI\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildhood parents\u0026rsquo; depressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.910\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.656\u0026ndash;2.204\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildhood friendship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.638\u0026ndash;0.821\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildhood parents\u0026rsquo; depressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.859\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.608\u0026ndash;2.149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildhood friendship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.750\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.658\u0026ndash;0.854\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModel 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildhood parents\u0026rsquo; depressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.694\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.460\u0026ndash;1.964\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildhood friendship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.700-0.914\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModel 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildhood parents\u0026rsquo; depressive symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.364\u0026ndash;1.865\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildhood friendship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.812\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.706\u0026ndash;0.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eModel 1 only included the childhood parents\u0026rsquo; depressive symptoms and childhood friendship. Model 2 adjusted the factors related to demographic characteristics (age, sex, marriage, education level). On the basis of model 2, model 3 adjusted the depression-related factors in childhood (childhood financial situation, childhood physical abuse and childhood social support). On the basis of model 3, model 4 adjusted additional factors related to depression in adulthood (alcohol use, combined with other chronic diseases, self-reported health).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section3\"\u003e \u003ch2\u003e3.2.2 Results of Sobel-Goodman mediation test\u003c/h2\u003e \u003cp\u003eWe also used Sobel-Goodman mediation test to study whether childhood friendship was the mediator between childhood parental depressive symptoms and adult depressive symptoms. Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e showed the results of test. Through the test, we found that childhood friendship did play an mediating role between the other two, and this indirect effect accounted for 6.14% of the total effect (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Sobel-Goodman mediation test supported the results of the previous logistic regression analysis.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMediation of childhood friendship in the association between childhood parental depressive symptoms and adult depression symptoms\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMediation of childhood friendship\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eAssociation of childhood parental depressive symptoms and adult depression symptoms\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEffect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCoefficient\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndirect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDirect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProportion of total effect that is mediated %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003ea The Sobel-Goodman test found childhood friendship was a mediator in the\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eassociation of childhood parental depression with adult depressive symptoms,\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003ewith a z value of 4.37(\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"4. DISCUSSION","content":"\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.1 The present situation of depressive symptoms in study population\u003c/h2\u003e \u003cp\u003e We selected 5565 participants with CVD who participated in the 2018 wave of the CHARLS national baseline survey as the study population. Among them, the population with significant depressive symptoms accounted for 43.94%, which was higher than that of the total population in the 2018 CHARLS survey. It shows that people who suffer from CVD are at high risk of adult depressive symptoms. This is consistent with the findings of other studies\u003csup\u003e[25, 43]\u003c/sup\u003e. CVD and depression are both diseases with high incidence worldwide\u003csup\u003e[24]\u003c/sup\u003e. Many studies have found that there were a certain relationship between the two diseases\u003csup\u003e[22, 23]\u003c/sup\u003e. Compared with that of the general population, patients with depression have a higher risk of CVD\u003csup\u003e[8, 44]\u003c/sup\u003e, and patients with CVD have a higher risk of depression\u003csup\u003e[21, 25]\u003c/sup\u003e. There is a tendency of co-disease between the two\u003csup\u003e[21, 22]\u003c/sup\u003e. And people who suffer from both depression and CVD have poorer treatment and more severe symptoms than that of others\u003csup\u003e[45]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003ePatients with specific diseases have a higher risk of depressive symptoms than patients in general\u003csup\u003e[5]\u003c/sup\u003e. Related studies have pointed out that this is partly due to the impact of the disease burden on patients\u003csup\u003e[5, 8]\u003c/sup\u003e. Therefore, patients with related diseases are often at high risk of developing depressive symptoms. The risk of developing depressive symptoms in other types of diseases is also worth exploring. Among them, patients with CVD are relatively special. Because the development of the disease is more likely to be affected by depressive symptoms than the other diseases\u003csup\u003e[8]\u003c/sup\u003e. Overall, people suffering from CVD should be the focus of our attention in the study of depression.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.2 The mediating effect of childhood friendship between childhood parental depressive symptoms and adult depressive symptoms\u003c/h2\u003e \u003cp\u003eIn patients with CVD, existing studies often focused on the effect of disease development on the depressive symptoms. Few studies have explored the effect of childhood-related factors. In our study, we found that individuals who had been exposed to depressed parents in childhood had a higher risk of developing depressive symptoms in adulthood than that of those who did not. It is consistent with the results of many studies on depressive symptoms between parents and children\u003csup\u003e[46\u0026ndash;48]\u003c/sup\u003e. In addition to the genetic predisposition to depression, offspring may also be influenced by parents who suffered from depression because of a negative living environment provided by depressed parents\u003csup\u003e[9]\u003c/sup\u003e. In most families, individuals must live with their parents for a long time before reaching adulthood. Children's mental health is mainly influenced by family factors and external environmental factors. Parents suffering from depression can hardly provide a stable, positive and healthy life for their offspring, and the frequency of negative childhood events will be higher\u003csup\u003e[14, 15]\u003c/sup\u003e. These are the risk factors of adult depressive symptoms \u003csup\u003e[14]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eWe also found that in childhood, individuals who had experienced friendship had a lower risk of adult depressive symptoms than that of those who had not. In other studies of depressive symptoms, friendship is also one of several protective factors that are often studied\u003csup\u003e[40]\u003c/sup\u003e. In childhood, friends and parents are the objects of long-term contact. Getting along well with each other is beneficial to the development of children's mental health. The existence of friendship depends on individual cognition. If a person thinks that he had a good time with his friends, it shows that there is a positive emotional memory (friendship) in his cognitive range. It partly explains why friendship is a protective factor for depression.\u003c/p\u003e \u003cp\u003eAlthough parental depressive symptoms and friendship are common influencing factors of adult depressive symptoms, there are few studies to analyze whether there is a certain relationship between the three. Moreover, in the study of mediators between parental and offspring depression, there are more negative mediating factors\u003csup\u003e[10, 27]\u003c/sup\u003e. In fact, reducing the emergence of risk factors and promoting the occurrence of protective factors are equally important for disease prevention. Our study shows that childhood friendship is a protective mediator between childhood parental depressive symptoms and adult depressive symptoms, and this mediating effect accounts for 6.14% of the total effect. It suggests that childhood parental depression can ultimately affect the occurrence of adult depressive symptoms by affecting childhood friendship. From a psychological point of view, individuals who have experienced negative psychological events may be more eager for a stable and positive emotional experience. Similarly, children who have long-term contact with depressed parents are more eager for emotional support than their peers. Reliable elders and friendly peers are good choices. Good friendship may effectively reduce the risk of adult depressive symptoms of individuals exposed to parental depressive symptoms. Our results also suggest that friendship can be used as an intervention for depression, especially for those who contact depressed parents. Some studies have taken the cultivation and promotion of friendship as an intervention for some diseases\u003csup\u003e[49, 50]\u003c/sup\u003e. We can also consider preventing depression by promoting the development of individual friendship.\u003c/p\u003e \u003cp\u003eFrom the point of view of life course epidemiology, the occurrence of diseases is the result of the joint action of all the risk factors that individuals come into contact with in their life course\u003csup\u003e[6]\u003c/sup\u003e. There is a certain relationship between depressive symptoms and related emotional events in early life\u003csup\u003e[14]\u003c/sup\u003e. However, these studies are usually carried out in the general population. Our study found that childhood-related events were still associated with adult depressive symptoms in patients with CVD. Compared with that of the general population, the situation of patients with CVD is relatively more complex. In addition to the effects of common life events, the pain caused by disease also continues to affect the patients. If the patients develop depressive symptoms at the same time, the two diseases will affect each other, leading to a worsening condition. Therefore, patients with CVD need to be more alert to the occurrence of depressive symptoms. Whether in patients with CVD or in the general population, childhood-related events may affect adult depressive symptoms. The results of this study can be deduced to people with other diseases or the general population.\u003c/p\u003e \u003cp\u003eIn the aspect of preventing depression, we should also consider the influence of individual's early life experience. At the same time, we should pay more attention to the high-risk groups of depression, such as children exposed to depressed parents. For children with depressed parents, it is difficult to separate parents from children. However, we can actively carry out depression surveys for adolescents to ensure that these high-risk groups will be identified as soon as possible. Then, schools or health institutions can organize relevant activities to promote the friendly relationship between these groups and their peers. In a word, early intervention to high-risk groups can effectively prevent the occurrence of depression.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Limitations\u003c/h2\u003e \u003cp\u003eIn our study, the population with CVD was identified by patients' self-reports. In other words, participants confirm current disease state by recalling whether they have been diagnosed with hypertension or heart disease by doctors. There is a drawback to this way of judgment. People who suffer from diseases but seldom go to hospitals for economic or other reasons are ignored. At the same time, self-reporting is less sensitive and specific than some techniques that identify diseases through tests.\u003c/p\u003e \u003cp\u003eThe depressive symptoms of parents in individual\u0026rsquo;s childhood is also obtained through participants\u0026rsquo; recollection. First of all, this will lead to the existence of a recall bias. According to the criteria of International Classification of Diseases-10(ICD-10), the judgment of depression depends on the typical symptoms and common symptoms of individuals. However, the specific symptoms related to parental depressive symptoms in childhood have been difficult to obtain. It's not just because it's an early event in life. In the age of the participants' parents, the medical service system is not perfect. At the same time, individuals are ashamed to conduct mental tests. It was difficult to obtain the medical reports of the participants' parents at that time. This information is available only through the patient's recollection. This can lead a certain impact to the study.\u003c/p\u003e \u003cp\u003eIn the 2018 wave of CHARLS national baseline Survey, CES-D 10 was used to measure depression in the study population. We used 10 points as a cut-off value of the scale to determine whether individuals had significant depressive symptoms. However, CES-D10 is more suitable for evaluating the severity of depressive symptoms than as a diagnostic screening tool. One study found that this screening method was less specific when using 8 and 10 as cutoff values to measure the sensitivity and specificity of the CES-D 10 tool for the diagnosis of depression\u003csup\u003e[51]\u003c/sup\u003e. It suggests that individuals who do not suffer from depression may be misjudged to be depressed.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. CONCLUSION","content":"\u003cp\u003ePeople with CVD is a high-risk group suffering from depression. Among middle-aged and elderly people with CVD in China, childhood parental depression can increase the risk of adult depressive symptoms. On the contrary, childhood friendship is the protective factor of adult depressive symptoms. In addition, childhood friendship is the mediating factor between childhood parental depression and adult depressive symptoms. It suggests that we can consider cultivating and promoting friendship as an intervention measure for depression in the group that exposed to depressed parents in childhood.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eCONFLICT OF INTERESTS\u003c/h2\u003e \u003cp\u003eNone declared.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFUNDING\u003c/h2\u003e \u003cp\u003eThis study was sponsored by Special Project of Hospital Development Research Center of Chengdu Medical College (Grant number: YYFZ21008).\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eRY.Y. and XJ.Y. conceived the study. The manuscript of this article was drafted by RY.Y. and XJ.Y. RY.Y., H.X. and HX.C. designed the writing strategies RY.Y., HX.C. and H.X. were involved in the statistical strategy for data analysis. All authors read and approved the final version of this article.\u003c/p\u003e\u003ch2\u003eACKNOWLEDGMENTS\u003c/h2\u003e \u003cp\u003eOur study is a secondary data analysis based on the public data of the China Health and Retirement Longitudinal Study(CHARLS). Thanks to Peking University for publishing CHARLS data for our research and analysis.\u003c/p\u003e\u003ch2\u003eDATA AVAILABILITY STATEMENT\u003c/h2\u003e \u003cp\u003eData supporting the results of this study are available from the corresponding authors on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization.. The global burden of disease: 2004 update. \u003cem\u003eGeneva: World Health Organization\u003c/em\u003e 2008.\u003c/li\u003e\n\u003cli\u003eGBD 2016 DALYs and HALE Collaborators. 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Beyond Social Skills: Supporting Peer Relationships and Friendships for School-Aged Children with Autism Spectrum Disorder. \u003cem\u003eSemin Speech Lang\u003c/em\u003e 2018; \u003cstrong\u003e39\u003c/strong\u003e: 178\u0026thinsp;\u0026minus;\u0026thinsp;94.\u003c/li\u003e\n\u003cli\u003eBj\u0026ouml;rgvinsson T, Kertz SJ, Bigda-Peyton JS, McCoy KL, Aderka IM. Psychometric properties of the CES-D-10 in a psychiatric sample. \u003cem\u003eAssessment\u003c/em\u003e 2013; \u003cstrong\u003e20\u003c/strong\u003e: 429\u0026thinsp;\u0026minus;\u0026thinsp;36.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Childhood parental depressive symptoms, Childhood friendship, Depressive symptoms, Cardiovascular disease, China","lastPublishedDoi":"10.21203/rs.3.rs-4548466/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4548466/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e \u003cp\u003eIndividuals whose parents had depressive symptoms in childhood are more likely to develop depressive symptoms in adulthood than the general population. Few studies have explored the association between the above two in patients with cardiovascular disease(CVD). In addition, it is not clear whether childhood friendship plays an intermediary role between childhood parents' depressive symptoms and adult depressive symptoms.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003e In our study, we selected people suffering from CVD who participated in the China Health and Retirement Longitudinal Study (CHARLS) life history survey and 2018 wave of CHARLS national baseline survey. We made statistical analysis on the assumption that childhood friendship was the mediator between childhood parental depression and adult depressive symptoms. Multi-level logistic regression analysis and Sobel Goodman mediation test were used to measure the association between childhood parental depression, childhood friendship and adult depressive symptoms.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 5565 participants were included in our study. The proportion of people with CVD having significant depressive symptoms accounted for 43.94%, which was higher than that of total population in the same period(36.62%, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.05). The results of logistic regression analysis showed that childhood parental depressive symptoms increased the risk of adult depressive symptoms(Model 3, \u003cem\u003eOR\u003c/em\u003e: 1.621, 95%\u003cem\u003eCI\u003c/em\u003e: 1.387\u0026ndash;1.895). In contrast, childhood friendship was a protective factor for adult depressive symptoms (Model 3, \u003cem\u003eOR\u003c/em\u003e: 0.788, 95%CI: 0.685\u0026ndash;0.906), and played an intermediary role between childhood parental depressive symptoms and adult depressive symptoms. Through the Sobel-Goodman test, we found that the mediating effect of childhood friendship between the other two accounted for 6.14% of the total effect (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIn middle-aged and elderly Chinese with CVD, childhood friendship is a protective factor of adult depressive symptoms, and it is the mediator between childhood parental depression and adult depressive symptoms.\u003c/p\u003e","manuscriptTitle":"The Protective Role of Childhood Friendship on the Effects of Parental Depressive Symptoms and Adult Depressive Symptoms among People with Cardiovascular Disease","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-18 15:52:47","doi":"10.21203/rs.3.rs-4548466/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6022ff6f-e985-42f9-a675-d47a3e6f8e92","owner":[],"postedDate":"July 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":34232115,"name":"Health sciences/Medical research/Epidemiology"},{"id":34232116,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2024-09-18T13:21:33+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-18 15:52:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4548466","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4548466","identity":"rs-4548466","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}