Impact of childhood maltreatment on outcomes of antidepressant medication in chronic and/or recurrent depression

Medeiros, Gustavo C.; Prueitt, William L.; Rush, A. John; Minhajuddin, Abu; Czysz, Andrew H.; Patel, Shirali S.; Trombello, Joseph M.; Trivedi, Madhukar H.

doi:10.1016/j.jad.2021.04.022

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…Depressive episode was thoroughly assessed by administering the 30-item Inventory of Depressive Symptomatology-Clinician Rating (IDS-C 30 ) (Corruble et al , 1999) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-C 16 ) (Rush et al , 2003), the Concise Associated Symptoms Tracking (CAST) (Trivedi et al , 2011a) and Concise Health Risk Tracking (CHRT) (Trivedi et al , 2011b) scales, which respectively, assessed irritability and suicide propensity and ideation, the Altman Self-Rating Mania Scale (ASRM) (Altman, 1998) to ascertain intra-MDE hypomanic symptoms and the Work and Social Adjustment Scale (WSAS) (Mundt et al , 2002) to ascertain functional impairment. The individual assessment was completed by the Psychiatric Diagnostic Screening Questionnaire (PDSQ) (Zimmerman and Mattia, 1999), which investigated comorbid PTSD (post-traumatic scale ≥8) and anxiety disorders, and a questionnaire that was specifically developed to explore CMT subtypes (Medeiros et al , 2021).…”

Section: Methodsmentioning

confidence: 99%

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Post-traumatic stress disorder and childhood emotional abuse are markers of subthreshold bipolarity and worse treatment outcome in major depressive disorder

Olgiati

Serretti

2021

International Clinical Psychopharmacology

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Post-traumatic stress disorder (PTSD) and childhood maltreatment (CMT: parental neglect; emotional, physical and sexual abuse) have been linked to bipolar disorder but they are also common in major depressive disorder (MDD). Our objective was to investigate their association with the bipolar spectrum and antidepressant treatment outcome in 482 outpatients with DSM-IV MDD treated in the Combining Medications to Enhance Depression Outcomes trial for 28 weeks Bipolar spectrum score included age of onset <21 years, subthreshold hypomania (a period of elated or irritable mood with at least two concurrent hypomanic symptoms, which did not fulfill DSM criteria for hypomanic/manic episode) and depressive mixed state (DMX). PTSD subjects (n = 107; 22%) had more severe depression (P < 0.0001), work and social impairment (P = 0.0031), comorbid anxiety disorders (P < 0.0001) and increased suicidality (P = 0.0003). Bipolar spectrum score was higher with PTSD comorbidity (P = 0.0063) and childhood emotional abuse (P = 0.0001). PTSD comorbidity was associated with residual suicidality (P = 0.0218) after 6 weeks of antidepressant use whereas childhood emotional abuse [odds ratio (OR), 1.01-2.22], subthreshold hypomania (OR, 1.04-4.09) and DMX (OR, 1.00-4.19) were predictors of mood switch. These results corroborate the role of PTSD and childhood emotional abuse as markers of bipolar spectrum and prognostic factors during antidepressant treatment. Int

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Section: Methodsmentioning

confidence: 99%

“…In prior CO-MED analysis, Medeiros and colleagues (2021) investigated the impact of CMT on antidepressant-treatment outcomes. Here, instead, we focused on PTSD comorbidity and analyzed its association with response (>50% decrease in QIDS score from baseline) and remission (QIDS≤5) after six weeks of antidepressant use.…”

Section: Methodsmentioning

confidence: 99%

Post-traumatic stress disorder and childhood emotional abuse are markers of subthreshold bipolarity and worse treatment outcome in major depressive disorder

Olgiati

Serretti

2021

International Clinical Psychopharmacology

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“…This could imply that early life stress affects ventricular and white matter structure via a prolonged choroid plexus activation. However, a recent analysis, based on the self-report depression scale QIDS-SR did not confirm a difference regarding subjects with and without childhood adversity regarding clinical response 56 .…”

Section: Discussionmentioning

confidence: 88%

Brain Ventricle and Choroid Plexus Morphology as Predictor of Treatment Response: Findings from the EMBARC Study

Murck

Fava

Cusin³

et al. 2023

Preprint

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Recent observations suggest a role of the choroid plexus (CP) and cerebral ventricle volume (CV), to identify treatment resistance of major depressive disorder (MDD). We tested the hypothesis that these markers are associated with clinical improvement in subjects from the EMBARC study, as implied by a recent pilot study. The EMBARC study characterized biological markers in a randomized placebo-controlled trial of sertraline vs. placebo in patients with MDD. Association of baseline volumes of CV, CP and of the corpus callosum (CC) with treatment response after 4 weeks treatment were evaluated. 171 subjects (61 male, 110 female) completed the 4 week assessments; gender, site and age were taken into account for this analyses. As previously reported, no treatment effect of sertraline was observed, but prognostic markers for clinical improvement were identified. Responders (n = 54) had significantly smaller volumes of the CP and lateral ventricles, whereas the volume of mid-anterior and mid-posterior CC was significantly larger compared to non-responders (n = 117). A positive correlation between CV volume and CP volume was observed, whereas a negative correlation between CV volume and both central-anterior and central-posterior parts of the CC emerged. In an exploratory way correlations between enlarged VV and CP volume on the one hand and signs of metabolic syndrome, in particular triglyceride plasma concentrations, were observed. A primary abnormality of CP function in MDD may be associated with increased ventricles, compression of white matter volume, which may affect treatment response speed or outcome. Metabolic markers may mediate this relationship.

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“…The connection between traumatization in childhood and patients with a poorer treatment response is suggested by an overlap of structural changes: both conditions have increased volumes of the brain ventricles and reduced volumes of the corpus callosum 100,108 . As might be expected, several, 109,110 but not all 111 studies support the notion that patients with major depression and childhood trauma have a greater risk of not responding well to antidepressant therapy, 109,110 in accordance with the notion that these subjects may have larger ventricle volumes.…”

Section: Connection Of Morphological Brain Alterations To Neuroendocr...mentioning

confidence: 92%

A viewpoint on aldosterone andBMIrelated brain morphology in relation to treatment outcome in patients with major depression

Murck

Lehr

Ježová

2022

J Neuroendocrinology

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An abundance of knowledge has been collected describing the involvement of neuroendocrine parameters in major depression. The hypothalamic–pituitary–adrenocortical (HPA) axis regulating cortisol release has been extensively studied; however, attempts to target the HPA axis pharmacologically to treat major depression have failed. This review focuses on the importance of the adrenocortical stress hormone aldosterone, which is released by adrenocorticotropic hormone and angiotensin, and the mineralocorticoid receptor (MR) in depression. Depressed patients, in particular those with atypical depression, have signs of central hyperactivation of the aldosterone sensitive MR, potentially as a consequence of a reactive aldosterone release induced by low blood pressure and as a result of low sensitivity of peripheral MR. This is reflected in reduced heart rate variability, increased salt appetite and sleep changes in this group of patients. In addition, enlarged brain ventricles, compressed corpus callosum and changes of the choroid plexus are associated with increased aldosterone (in relation to cortisol). Furthermore, subjects with these features often show obesity. These characteristics are related to a worse antidepressant treatment outcome. Alterations in choroid plexus function as a consequence of increased aldosterone levels, autonomic dysregulation, metabolic changes and/or inflammation may be involved. The characterization of this regulatory system is in its early days but may identify new targets for therapeutic interventions.

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Impact of childhood maltreatment on outcomes of antidepressant medication in chronic and/or recurrent depression

Cited by 7 publications

References 30 publications

Post-traumatic stress disorder and childhood emotional abuse are markers of subthreshold bipolarity and worse treatment outcome in major depressive disorder

Post-traumatic stress disorder and childhood emotional abuse are markers of subthreshold bipolarity and worse treatment outcome in major depressive disorder

Brain Ventricle and Choroid Plexus Morphology as Predictor of Treatment Response: Findings from the EMBARC Study

A viewpoint on aldosterone andBMIrelated brain morphology in relation to treatment outcome in patients with major depression

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