Childhood Trauma May Cause Distinct Depression Subtype
Trauma in childhood is associated with changes in brain structure that appear to increase the risk of depression relapse in adults with major depressive disorder, according to a study in The Lancet Psychiatry.
“Our findings add further weight to the notion that patients with clinical depression who were mistreated as children are clinically distinct from non-maltreated patients with the same diagnosis," said lead researcher Nils Opel, MD, from the University of Münster, Germany.
Although previous studies have suggested links between child maltreatment and altered brain structure as well as between maltreatment and major depressive disorder, this study directly establishes an association among all three: maltreatment experiences in childhood, alterations in brain structure, and the clinical course of major depressive disorder.
The study involved 110 adults receiving inpatient care for major depressive disorder. Participants underwent structural magnetic resonance imaging (MRI) scans at baseline and were followed for 2 years. During the follow-up period, 75 participants experienced depression relapse.
Both childhood maltreatment and depression relapse over the follow-up period were associated with similar reductions in the surface area of the brain’s insular cortex, researchers reported. The reduction, which is in a brain area believed to help regulate emotion and self-awareness, appears to make relapse more likely.
Researchers concluded childhood maltreatment may cause a clinically and biologically distinct major depressive disorder subtype and recommended further research investigating the issue.
“Given the impact of the insular cortex on brain functions such as emotional awareness, it's possible that the changes we saw make patients less responsive to conventional treatments,” Dr. Opel said. “Future psychiatric research should therefore explore how our findings could be translated into special attention, care, and treatment that could improve patient outcomes.”
—Jolynn Tumolo
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