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Early childhood abuse doubles the risk for lifetime recurrence of depression

Dominika Osmolska Psy.D.'s picture

Abuse or mistreatment in early childhood might predispose individuals towards a lifetime struggle with depression. A new study points to the lifetime risk being doubled for survivors of childhood physical, emotional and/or sexual abuse.

Compounding the sad news is the fact that these individuals are also less likely to respond well to psychological or drug-based treatments.

Researchers at the Institute of Psychiatry (IoP) at King's College London pooled information from 26 studies that included data from more than 26,000 people. "What we have observed is that childhood maltreatment predicts recurrence, the persistence of the episodes and response to treatment," said Andrea Danese, a clinical lecturer in child and adolescent psychiatry at the IoP, who led the work.

Depression affects an average of 10% of the population at any one time, according to the Centers for Disease Control ( CDC)., and the World Health Organization predicts that depression will become the second most prominent contributor to the global burden of disease across all ages by 2020. It already is in the age category 15-44 years for both sexes combined.

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In their meta-analysis, the researchers examined data from 16 epidemiological studies involving more than 23,000 people and 10 clinical trials involving more than 3,000 people. Rudolf Uher of the IoP, who co-authored the study, said the researchers used five indicators of maltreatment in analyzing the work: rejecting interaction from a mother; harsh discipline reported by a parent; unstable primary caregiver arrangement throughout childhood; and self-reports of harsh physical or sexual mistreatment.

If an individual self-reported one of these indicators, he or she was classified as being a probable victim of past mistreatment. If a participant self-reported two or more of the indicators, they were classed as definitely mistreated.

The results of the study were published on Monday in the American Journal of Psychiatry. They showed that someone with one or more indicators of childhood mistreatment had a chance of developing recurrent episodes of depression in later life which was around 2.27 times higher than someone who had no history of mistreatment. They were also 43% more likely to experience a poor outcome when it came to psychological or drug-based treatment.

Abuse and mistreatment in childhood seems to have a profound impact on an individual’s ability to have positive outcomes later in life. Childhood is a time when, optimally, we have a chance to learn how to cope with adversity through modeling and support from mentoring adults. These skills help us become more resilient in the face of everyday challenges. Individuals who are abused and mistreated, however, do not have the opportunity to acquire these skills. Moreover, childhood abuse and traumatic events have been shown to affect and even permanently damage the brain, the hormonal and the immune systems as a result of the stress placed on their bodies.

"There are a number of research papers showing that, for example, maltreated children have, already in childhood, abnormalities in the pre-frontal cortex that may have an impact on their neuropsychological function, especially executive function, things like sustained attention or regulating emotions," said Andrea Danese, a clinical lecturer in child and adolescent psychiatry at the IoP, who led the work. These biological differences might explain some of the observed increase in recurrent depression, he said, but that link would have to be established in further research.