Associations of childhood trauma with remission and treatment response after 12 weeks of selective serotonin reuptake inhibitor treatment in patients with major depressive disorder

Objective

To explore the associations of childhood trauma and its subtypes with remission and treatment response after 12 weeks of selective serotonin reuptake inhibitor (SSRI) treatment among patients with major depressive disorder (MDD).

Methods

Data were from patients with MDD in the Depression Cohort in China. At baseline, the Childhood Trauma Questionnaire-Short Form was used to assess childhood trauma, including physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect. After 12 weeks of SSRI treatment, depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9). Remission was defined as a PHQ-9 score < 5, and response was defined as a ≥ 50 % decline in the PHQ-9 score from baseline.

Results

The sample included 572 patients with MDD (mean [SD] age, 27.4 [7.2] years; 30.6 % male). After receiving 12 weeks of SSRI treatment, 32.2 % of patients achieved remission and 49.1 % of patients responded to treatment. After fully adjusting for confounders, patients with childhood trauma (OR, 0.55; 95 % CI, 0.36 to 0.84), physical abuse (OR, 0.43; 95 % CI, 0.23 to 0.79), emotional abuse (OR, 0.40; 95 % CI, 0.24 to 0.67), or sexual abuse (OR, 0.49; 95 % CI, 0.24 to 0.99) had a lower likelihood of remission, but those with physical neglect or emotional neglect did not. The response showed similar results.

Conclusions

Among patients with MDD, childhood abuse (i.e., physical abuse, emotional abuse, and sexual abuse), but not childhood neglect (i.e., physical neglect and emotional neglect), was associated with a lower likelihood of remission and response after 12 weeks of SSRI treatment.