New study | Adults with a history of childhood trauma may benefit from recommended treatment options for depression

• The largest and most comprehensive study of its kind examining the effectiveness of treatment options for depression in adults with childhood traumatic experiences and comparing this population with those without childhood Comparison of traumatic experiences in depressed adult patients.

• Contrary to previous research findings, this study shows that adults with a history of childhood trauma experience symptom relief after receiving currently recommended medications and psychotherapy for depression.

• The authors call for treatment for people with depression regardless of childhood trauma status, as well as further research on long-term treatment outcomes and residual symptoms after treatment, as there may still be a need to inform people who have experienced childhood trauma of patients with additional interventions.

Adults with depression and a history of childhood trauma experience relief of symptoms with medication, psychotherapy, or a combination of treatments. A new study published in The Lancet Psychiatry suggests that, contrary to current theory, a common treatment for depression is Effective.

Childhood trauma (defined as emotional/physical neglect or emotional/physical/sexual abuse before age 18) is a risk factor for developing depression in adulthood, with symptoms often appearing earlier, Longer duration, more frequent episodes, and increased risk. Previous studies have shown that adults and adolescents with depression who experience childhood trauma are about 1.5 times more likely to be ineffective or not relieved after medication, psychotherapy, or combination therapy than those without childhood trauma.

“This study, the largest of its kind, examined the effectiveness of a treatment regimen for depression in adults with traumatic childhood experiences and was the first to compare the effects of positive treatment in this population with the A control group (waiting group, placebo, or usual care) was compared. About 46% of adults with depression had a history of childhood trauma, and for those with chronic depression, the proportion who experienced childhood trauma was even higher. Therefore, it was determined It is important whether existing treatment options for depression are effective in patients with traumatic childhood experiences,” said Erika Kuzminskaite, a doctoral student and lead author of the study. [1]

The researchers used data from 29 clinical trials of medication and psychotherapy for depression in adults, including up to 6,830 patients. Of these participants, 4,268 (62.5%) reported a history of childhood trauma. Most clinical trials (15, 51.7%) were conducted in Europe, followed by North America (9, 31%). The severity of depressive symptoms was assessed using the Beck Depression Inventory (BDI) or Hamilton Rating Scale for Depression (HRSD).

The three research questions examined were: whether patients with childhood trauma experience had more severe depressive symptoms before treatment, whether patients with childhood trauma experience had worse outcomes after active treatment, and Whether patients with childhood trauma experiences are less likely to benefit from active treatment compared to controls.

Consistent with previous research, patients with childhood trauma experience had more severe symptoms at the start of treatment than patients without childhood trauma, suggesting that this should be taken into account when estimating treatment effects The severity of symptoms is important.

Although patients with childhood trauma reported more depressive symptoms at the beginning and end of treatment, symptom relief was similar to patients without childhood trauma. Treatment dropout rates were also similar for patients with or without childhood trauma. Treatment outcomes assessed did not differ by type of childhood trauma, diagnosis of depression, method of assessment of childhood trauma, study quality, year, type of treatment, or duration of treatment.

Erika Kuzminskaite said, “The finding that patients with depression and childhood trauma experience similar outcomes to those without trauma may offer hope to those who have experienced childhood trauma. Although As such, residual symptoms after treatment in patients with childhood trauma deserve more clinical attention, as they may still need to be offered additional interventions in order to further meaningfully improve treatment outcomes for those with childhood trauma. And to improve its outcomes, future research is warranted to explore long-term treatment outcomes and the mechanisms by which childhood trauma has long-term effects.”[1]

The authors acknowledge some limitations of this study, including the wide variation in the results of the studies included in the meta-analysis and the fact that all cases of childhood trauma were reported retrospectively. Meta-analyses focus on symptom relief during the acute treatment phase, but patients with both depression and childhood trauma experience tend to have residual symptoms after treatment and are at high risk of relapse, so they may benefit from treatment in the long run Fewer patients with no childhood trauma experience. The study design also did not take into account gender differences.

Antoine Yrondi of the University of Toulouse, France, who was not involved in the study, wrote in a related comment: “This meta-analysis can convey a sense of The message of hope is that evidence-based psychotherapy and medication can alleviate depressive symptoms. However, physicians should also be aware that childhood trauma may be associated with clinical features that may make it more difficult to fully relieve symptoms, which in turn affects daily functioning.” END


This study conducted by researchers from Vrije University, Amsterdam, Netherlands.

[1] Quote direct from author and cannot be found in the text of the Article.

*The Chinese translation is for reference only, and the original text of the press release shall prevail.