Citation

Tunnard C, Rane LJ, Wooderson SC, Markopoulou K, Poon L, Fekadu A, Juruena M, Cleare AJ. J. Affect. Disord. 2014; 152-154: 122-130.

Affiliation

Division of Psychological Medicine and Psychiatry, Section of Neurobiology of Mood Disorders, Institute of Psychiatry, King's College London, 103 Denmark Hill, London SE5 8AZ, UK; The National Affective Disorder Unit, South London and Maudsley NHS Foundation Trust, UK.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.jad.2013.06.037

PMID

23880448

Abstract

BACKGROUND: Childhood adversity is a risk factor for the development of depression and can also affect clinical course. We investigated this specifically in treatment-resistant depression (TRD). METHODS: One hundred and thirty-seven patients with TRD previously admitted to an inpatient affective disorders unit were included. Clinical, demographic and childhood adversity (physical, sexual, emotional abuse; bullying victimization, traumatic events) data were obtained during admission. Associations between childhood adversity, depressive symptoms and clinical course were investigated. RESULTS: Most patients had experienced childhood adversity (62%), with traumatic events (35%) and bullying victimization (29%) most commonly reported. Childhood adversity was associated with poorer clinical course, including earlier age of onset, episode persistence and recurrence. Logistic regression analyses revealed childhood adversity predicted lifetime suicide attempts (OR 2.79; 95% CI 1.14, 6.84) and childhood physical abuse predicted lifetime psychosis (OR 3.42; 95% CI 1.00, 11.70). LIMITATIONS: The cross-sectional design and retrospective measurement of childhood adversity are limitations of the study. CONCLUSIONS: Childhood adversity was common amongst these TRD patients and was associated with poor clinical course, psychosis and suicide attempts. Routine assessment of early adversity may help identify at risk individuals and inform clinical intervention.

Language: en