Childhood Abuse Linked with Depression, Resistance to Treatment

Be Honest with Your Doctor About Your Past

Childhood Abuse Linked with Depression, Resistance to Treatment

By Depression Connect StaffA Published at September 20, 2011 Views 3,301 Comments 2 Likes 5

Depressed patients with a history of childhood abuse or neglect need to be honest with their doctors about their past, because it could seriously impact their treatment and recovery.

A recent study found adults who were mistreated as children are twice as likely as those who had normal childhoods to experience lasting bouts of depression. While that finding may not come as a surprise, scientists also found childhood abuse increased risk of responding poorly to standard treatments.  

“Identifying those at risk of multiple and long-lasting depressive episodes is crucial from a public health perspective,” Dr Andrea Danese, senior investigator of the study, said in a press release.

For the study, researchers from King’s College London Institute of Psychiatry reviewed 16 previously published studies in scientific and medical journals. Out of the 23,000 combined study participants, 9 percent had “definite” maltreatment – such as neglect or physical or sexual abuse – and of those patients, 31.5 percent then went on to develop depression. That compared to a 12.5 percent rate of developing depression for those who had no maltreatment.

Furthermore, the scientists found antidepressant medication, psychological treatment, or combinations of the two were less effective in those who suffered childhood abuse.

The King researchers said previous studies show mistreated children and adults have more "biological abnormalities" in systems sensitive to psychological stress, such as the brain, the endocrine, and the immune system. These abnormalities could explain why individuals with a history of abuse respond poorly to treatment for depression.

Doctors treating people for depression should delve into the childhoods of their patients before prescribing treatment, the researchers said, since it could prove valuable in determining their prognosis. Patients, in turn, need to be honest with doctors about their past to ensure they receive the best care.

Finally, doctors and scientists should look for new kinds of treatments and ways of intervening earlier in childhood abuse cases as a way to reduce the international effect of depression.

Around one in 10 children worldwide are exposed to maltreatment including psychological, physical or sexual abuse or neglect. The World Health Organization estimates that by 2020, depression will be the second-leading contributor to the world's global disease burden.

"Therefore prevention and early therapeutic interventions targeting childhood maltreatment could prove vital in helping prevent the major health burden owing to depression,” Danese said.

The study was published in the August issue of the American Journal of Psychiatry.

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