Abstract

OBJECTIVES
Evidence suggests that childhood maltreatment may negatively affect not only the lifetime risk of depression but also clinically relevant measures of depression, such as course of illness and treatment outcome. The authors conducted the first meta-analysis to examine the relationship between childhood maltreatment and these clinically relevant measures of depression.
METHOD
The authors conducted searches in MEDLINE, PsycINFO, and Embase for articles examining the association of childhood maltreatment with course of illness (i.e., recurrence or persistence) and with treatment outcome in depression that appeared in the literature before December 31, 2010. Recurrence was defined in terms of number of depressive episodes. Persistence was defined in terms of duration of current depressive episode. Treatment outcome was defined in terms of either a response (a 50% reduction in depression severity rating from baseline) or remission (a decrease in depression severity below a predefined clinical significance level).
RESULTS
A meta-analysis of 16 epidemiological studies (23,544 participants) suggested that childhood maltreatment was associated with an elevated risk of developing recurrent and persistent depressive episodes (odds ratio=2.27, 95% confidence interval [CI]=1.80–2.87). A meta-analysis of 10 clinical trials (3,098 participants) revealed that childhood maltreatment was associated with lack of response or remission during treatment for depression (odds ratio=1.43, 95% CI=1.11–1.83). Meta-regression analyses suggested that the results were not significantly affected by publication bias, choice of outcome measure, inclusion of prevalence or incidence samples, study quality, age of the sample, or lifetime prevalence of depression.
CONCLUSIONS
Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression.

Links

Publisher Full Text

Authors

Nanni V, Uher R, Danese A

Institution

King's College London, Institute of Psychiatry, MRC Social, Genetic, and Developmental Psychiatry Research Centre, UK.

Source

The American journal of psychiatry 169:2 2012 Feb pg 141-51

MeSH

Adult
Adult Survivors of Child Abuse
Antidepressive Agents
Child
Child Abuse
Confidence Intervals
Depressive Disorder
Drug Therapy
Epidemiologic Studies
Episode of Care
Humans
Outcome and Process Assessment (Health Care)
Prevalence
Psychiatric Status Rating Scales
Recurrence
Remission Induction
Risk Factors
Treatment Failure

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22420036