Institute of Psychiatry, Department of Psychological Medicine, Section of Neurobiology of Mood Disorders, 103 Denmark Hill, Box P074, London SE5 8AZ, United Kingdom; National Affective Disorder Unit, South London and Maudsley NHS Foundation Trust, United Kingdom; Department of Psychiatry, School of Medicine, Addis Ababa University, Ethiopia; Department of Neurosciences and Behaviour, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
Tunnard, C., Institute of Psychiatry, Department of Psychological Medicine, Section of Neurobiology of Mood Disorders, 103 Denmark Hill, Box P074, London SE5 8AZ, United Kingdom, National Affective Disorder Unit, South London and Maudsley NHS Foundation Trust, United Kingdom; Rane, L.J., Institute of Psychiatry, Department of Psychological Medicine, Section of Neurobiology of Mood Disorders, 103 Denmark Hill, Box P074, London SE5 8AZ, United Kingdom, National Affective Disorder Unit, South London and Maudsley NHS Foundation Trust, United Kingdom; Wooderson, S.C., Institute of Psychiatry, Department of Psychological Medicine, Section of Neurobiology of Mood Disorders, 103 Denmark Hill, Box P074, London SE5 8AZ, United Kingdom, National Affective Disorder Unit, South London and Maudsley NHS Foundation Trust, United Kingdom; Markopoulou, K., Institute of Psychiatry, Department of Psychological Medicine, Section of Neurobiology of Mood Disorders, 103 Denmark Hill, Box P074, London SE5 8AZ, United Kingdom, National Affective Disorder Unit, South London and Maudsley NHS Foundation Trust, United Kingdom; Poon, L., National Affective Disorder Unit, South London and Maudsley NHS Foundation Trust, United Kingdom; Fekadu, A., Institute of Psychiatry, Department of Psychological Medicine, Section of Neurobiology of Mood Disorders, 103 Denmark Hill, Box P074, London SE5 8AZ, United Kingdom, Department of Psychiatry, School of Medicine, Addis Ababa University, Ethiopia; Juruena, M., Institute of Psychiatry, Department of Psychological Medicine, Section of Neurobiology of Mood Disorders, 103 Denmark Hill, Box P074, London SE5 8AZ, United Kingdom, Department of Neurosciences and Behaviour, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil; Cleare, A.J., Institute of Psychiatry, Department of Psychological Medicine, Section of Neurobiology of Mood Disorders, 103 Denmark Hill, Box P074, London SE5 8AZ, United Kingdom, National Affective Disorder Unit, South London and Maudsley NHS Foundation Trust, United Kingdom
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. © 2013 Elsevier B.V.