Sexual abuse history and psychotropic use characteristics of inpatient children and adolescents with major depressive disorders

Objective

This study aimed to investigate the clinical and psychopharmacologic characteristics of child and adolescent inpatients diagnosed with major depressive disorder (MDD), with and without a history of sexual abuse.

Methods

The 337 consecutive patients who were followed up in a University Child and Adolescent Psychiatry inpatient clinic between 2017 and 2019 were evaluated, and 149 were diagnosed with MDD. MDD diagnosed children and adolescents were divided into two groups based on whether they had a history of sexual abuse (n = 44; Group 1) or did not (n = 105; Group 2).

Results

The mean age of group 1 was 14.6 ± 1.6 years (range: 6–18) and group 2 was 14.6 ± 2.2 years (range: 6–18). Group 1 had a significantly higher prevalence of psychiatric comorbidities (p = 0.002), non-suicidal self-injury (p = 0.018), domestic violence (p = 0.008), physical (p = 0.008) and emotional abuse history (p = 0.007), and a longer duration of hospitalization (p < 0.0001). Antipsychotic combination therapy (χ² = 10.772; p = 0.005) and total chlorpromazine equivalent doses were also higher in the sexually abused group (Z = −2.749; p = 0.006).

Conclusion

These findings suggest that depressive symptoms in sexually abused children and adolescents may be more resistant to psychopharmacological treatment. Further studies are needed to determine whether these differences are attributable to the neurochemical and neuroanatomical effects of trauma or psychiatric comorbidities.