A study that was newly published in the journal The Lancet Psychiatry shows that adults who have a major depressive disorder and had experienced childhood trauma can get some relief with recommended treatments.
Depressed Person
Results in this research challenge what many people currently think about treatments for this group of patients. The popular belief is that pharmacotherapy or psychotherapy, or a mix of both, has little or nothing to offer adults with depression fueled by a childhood trauma experience.
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This study, which the researchers described as the “largest of its kind,” proved that treatments can be helpful to these patients as they are to other patients.
Childhood trauma and depression
Scientists say childhood trauma is a prime risk factor for having a major depressive disorder as an adult. It refers to neglect or abuse – physical, emotional, or sexual – that a person experienced during childhood (before turning 18 years).
People who suffer childhood trauma tend to produce depression symptoms earlier, more often, and longer than others. This group of patients is also at a greater risk of morbidity.
Erika Kuzminskaite, the first author of this study, stated that roughly 46 percent of adults dealing with depression suffered childhood trauma. The percentage of such individuals among people with chronic depression symptoms is even greater.
“It is therefore important to determine whether current treatments offered for major depressive disorder are effective for patients with childhood trauma,” she said.
Earlier research suggested that adults and young people with depression and a history of childhood trauma have a higher tendency to not respond to treatments, compared to people with depression and no childhood trauma. Researchers reckoned that these patients were about 1.5 times less likely to respond to pharmacotherapy, psychotherapy, or combo treatment.
Proving treatment benefits
The scientists evaluated three research questions, including whether:
- Patients with childhood trauma had more severe depression symptoms before treatment
- There were more adverse effects among these patients after receiving active treatments
- Patients with a history of childhood trauma had lower chances of benefitting from treatment, compared to control
Read also: Childhood Abuse Leaves Scars on DNA That Could Be Passed to Offspring
To come up with their findings, the research team analyzed data from almost 30 clinical trials involving pharmacotherapy and psychotherapy treatments for depression patients. The studies included in this meta-analysis had 6,830 adult patients in all. Of these subjects, 62.5 percent (4,268) reported going through childhood trauma.
The bulk of the trials (15) was done in Europe while nine were carried out in America. The Hamilton Rating Scale for Depression (HRSD) or Beck Depression Inventory (BDI) was used for measuring depression severity.
Kuzminskaite and her colleagues found that patients with childhood trauma displayed more severe symptoms, compared to those without childhood trauma history, before starting treatment. This aligned with findings in other, earlier studies. The team explained that this suggests that symptom severity ought to be considered when assessing treatment efficacy.
The researchers revealed that patients with childhood trauma felt similar improvement in symptoms to those without the same following treatment. This is regardless of the fact that the group reported more serious symptoms both when treatment began and ended.
“Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma,” Kuzminskaite said.
The measured efficacy of treatment based on diverse factors, including the type of childhood trauma and how it is assessed, did not vary. The rates at which patients dropped out from treatment were also comparable between trauma and non-trauma groups.
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Kuzminskaite noted that residual symptoms in childhood trauma patients hinted at a need for greater clinical attention. This is because further interventions may be necessary.
This research has its limitations, however, which the team admitted. For example, its design failed to account for gender differences, and childhood trauma experiences were reported in retrospect. Treatment benefits for patients with a trauma history may also be lower over time because the study focused on improvement during the acute treatment stage.
There is a need for more research to learn more about the outcomes of long-term treatments, noted Kuzminskaite. Scientists also have to find out the mechanisms that childhood trauma relies on to produce its long-lasting effects.
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