Objective To explore the correlation of childhood abuse and plasma leptin in patients with major depression disorder with psychotic features. Methods A total of 150 eligible patients with major depression disorder were selected. The Childhood Trauma Questionnaire（CTQ），Hamilton Depression Rating Scale（ HAMD-24） and Symptom Checklist 90（ SCL-90） was used to assess the child abuse status， the severity of depression and the severity of psychotic symptoms. According to the SCL-90 score， the patients were divided into study group（ 56 cases with psychotic symptoms） and control group（ 94 cases without psychotic symptoms）. The plasma leptin level was determined by enzyme-linked immunosorbent assay（ ELISA）. Results （1）The age and the age of first onset of the study group were both lower than those of the control group［ （35.4±14.1） vs （41.8±12.4），t=2.76，P=0.005；25（20，36） vs 31（23，41），Z=2.531，P=0.011］. The difference of the proportion of each relationship between parents was statistically significant（ χ2=10.78，P=0.010）. The study group had the highest proportion of "emotionally poor"［ 44.6%（25/56）］， while the control group had the highest proportion of "emotionally average"［ 51.1%（48/94）］.（ 2）The total incidence of childhood abuse［ 48.2%（27/56） and 29.8%（ 28/94）］ and the incidence of emotional neglect［ 33.9%（ 19/56） and 19.1%（ 18/94）］ were significantly different between the two groups（ all P ＜ 0.05）. In both groups， emotional neglect was the most common， followed by physical neglect， and sexual abuse was the least common.（ 3）The plasma leptin level in the study group［ （4.685±2.462） μg/L］ was lower than that in the control group［ （6.860±3.972） μg/L；P ＜ 0.001］. Conclusions Childhood abuse and low plasma leptin level may be riskfactors of depression with psychotic symptoms.