Depression treatments effective for childhood trauma - British Herald
November 26, 2022
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Adults with a history of childhood trauma can benefit from depression treatments

The Lancet Psychiatry: Adults with a history of childhood trauma can benefit from recommended depression treatments, contrary to current theory

The largest and most comprehensive study of its kind examines the effectiveness of depression treatments on adults with childhood trauma and compares this population to adults diagnosed with major depressive disorder without childhood trauma.
Contrary to previous findings, this study suggests adults with a history of childhood trauma experience symptom improvement after medication and psychotherapy, currently recommended as a treatment for major depressive disorder.
Authors call for therapies to be offered to patients with major depressive disorder, regardless of their childhood trauma status, along with further research into long-term treatment outcomes and residual post-treatment symptoms as additional interventions for childhood trauma patients may still be needed.
Adults with major depressive disorder who have a history of childhood trauma experience symptom improvement after pharmacotherapy, psychotherapy, or combination treatment. The results of a new study, published in The Lancet Psychiatry, suggest that, contrary to current theory, these common treatments for major depressive disorder are effective for patients with childhood trauma.

Childhood trauma (defined as emotional/physical neglect or emotional/physical/sexual abuse before the age of 18) is known to be a risk factor for the development of major depressive disorder in adulthood, often producing symptoms that are earlier onset, longer lasting/more frequently recurring, and with increased risk of morbidity. Previous studies have suggested that adults and adolescents with depression and childhood trauma were around 1.5 times more likely to not respond or remit after pharmacotherapy, psychotherapy, or combination treatment, than those without childhood trauma.

“This study is the largest of its kind to look at the effectiveness of depression treatments for adults with childhood trauma and is also the first to compare the effect of active treatment with control condition (waitlist, placebo, or care-as-usual) for this population. Around 46% of adults with depression have a history of childhood trauma, and for chronic depression sufferers the prevalence is even higher. It is therefore important to determine whether current treatments offered for major depressive disorder are effective for patients with childhood trauma,” says PhD Candidate and first author of the study, Erika Kuzminskaite. [1]

The researchers used data from 29 clinical trials of pharmacotherapy and psychotherapy treatments for major depressive disorder in adults, covering a maximum of 6,830 patients. Of the participants, 4,268 or 62.5% reported a history of childhood trauma. Most of the clinical trials (15, 51.7%) were conducted in Europe, followed by North America (9, 31%). Depression severity measures were determined using the Beck Depression Inventory (BDI) or Hamilton Rating Scale for Depression (HRSD).

The three research questions tested were: whether childhood trauma patients were more severely depressed prior to treatment, whether there were more unfavourable outcomes following active treatments for patients with childhood trauma, and whether childhood trauma patients were less likely to benefit from active treatment than control condition.

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