The impact of childhood adversity on suicidality and clinical course in treatment-resistant depression
C Tunnard, LJ Rane, SC Wooderson… - Journal of affective …, 2014 - Elsevier
Journal of affective disorders, 2014•Elsevier
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 …
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 …
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.
Elsevier
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