Association between childhood maltreatment patterns and comorbidity of depression and anxiety in left-behind children: a latent class analysis

Abstract Background Childhood maltreatment (CM) represents a significant risk factor for depression and anxiety symptoms, with left-behind children (LBC) demonstrating heightened exposure. Existing studies have been restricted to certain types of CM, and paid little attention to comorbidity of depression and anxiety in LBC. This study aimed to comprehensive assess the association between CM patterns and comorbidity of depression and anxiety in LBC. Method A total of 7928 LBC was included in this cross-sectional study. Latent class analysis was used to identify the CM patterns. Logistic regression was used to investigate the association between CM patterns and comorbidity of depression and anxiety. Subgroup analyses were further used to assess the heterogeneity in the association between CM patterns and comorbidity of depression and anxiety. Results Three CM patterns were identified in this study. Compared to LBC from the least maltreatment group, those from the low abuse and high neglect group (OR: 1.95; 95% CI: 1.73–2.21), and severe maltreatment group (OR: 7.83; 95% CI: 6.17–9.93) showed stronger association between CM patterns and comorbidity of depression and anxiety. Notably, subgroup analysis unveiled significant interactions between the sex and CM patterns (P for interaction < 0.05), and female LBC showed stronger association between CM patterns and comorbidity of depression and anxiety. Conclusions These findings identify distinct CM-based risk profiles and emphasize the urgent need to develop targeted interventions informed by these patterns among LBC, especially female LBC, to mitigate the risk of unfavorable psychological health outcomes.