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BackgroundThe Chinese Great Famine caused widespread starvation in 1959–1961. Its long-term association with depressive symptoms has not been studied.AimsTo estimate the burden of depressive symptoms and the association of famine exposure with depressive symptoms.MethodThe China Health and Retirement Longitudinal Study is a nationwide representative survey of 17 708 Chinese adults aged ≥45. Propensity score matching and modified Poisson regression were used to evaluate the association between self-reported famine exposure in early life and depressive symptoms among the overall participants. Such associations were also assessed by developmental stage using modified Poisson regression and logistic regression.ResultsThe prevalence of depressive symptoms was 26.2% (95% CI 25.1–27.3%) in 2011. As defined by loss of family members because of starvation, 11.6% (95% CI 10.1 …