Early-Life Famine Exposure and the Risk of Depression and Anxiety in Adulthood: Evidence from the China Multi-Ethnic Cohort (CMEC)

Background Depression and anxiety are significant public health concerns worldwide and among the most common mental disorders. The impact of early-life famine exposure on mental health has increasingly drawn attention. However, research on the association between early-life famine exposure and the risk of depression and anxiety in adulthood, especially across different ethnic backgrounds, remains scarce in worldwide. Methods The study is based on the baseline data from the China Multi-Ethnic Cohort (CMEC), and includes 18,376 individuals who were born between 1939 and 1978 and experienced early life famine exposure. All participants underwent face-to-face interviews and physical examinations, and their anxiety and depression symptoms were assessed using the PHQ-2 and GAD-2 scales. Multivariable logistic regression analysis was conducted to examine the association between early-life famine exposure and the risk of depression and anxiety in adulthood. Results The study revealed that exposure to famine during childhood and adolescence significantly increases the risk of depressive symptoms in adulthood (childhood: OR = 1.65, 95% CI: 1.33–2.05; adolescence: OR = 1.64, 95% CI: 1.18–2.28). Among females, famine exposure during both childhood and adolescence was associated with a markedly elevated risk of adult depressive symptoms (childhood: OR = 1.87, 95% CI: 1.47–2.39; adolescence: OR = 1.96, 95% CI: 1.36–2.81). In the Han ethnic group, childhood famine exposure was significantly associated with an increased risk of depressive symptoms in later life (OR = 1.92, 95% CI: 1.44–2.56). In contrast, among the Yi ethnic group, fetal exposure to famine was significantly related to an increased risk of both depressive symptoms (OR = 2.33, 95% CI: 1.28–4.25) and anxiety symptoms in adulthood (OR = 1.99, 95% CI: 1.37–2.88), whereas no significant associations were observed in the Bai ethnic group. Regarding anxiety symptoms, males exposed to famine during childhood and adolescence were found to have a significantly reduced risk of developing anxiety symptoms in adulthood (childhood: OR = 0.53, 95% CI: 0.33–0.85; adolescence: OR = 0.32, 95% CI: 0.13–0.78). Among the Yi population, fetal famine exposure emerged as a significant risk factor for adult anxiety symptoms (OR = 1.99, 95% CI: 1.37–2.88). Conclusion Famine exposure during childhood and adolescence significantly impacts the risk of mental health disorders in adulthood, exhibiting different patterns across ethnic groups. Early-life nutritional deprivation may have long-term effects on mental health, with variations based on gender and ethnicity.