Article

Clinical characteristics and treatment outcome of depression in patients with and without a history of emotional and physical abuse.

Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, School of Medicine, University of Pisa, Italy.
Journal of Psychiatric Research (Impact Factor: 4.09). 10/2009; 44(5):302-9. DOI: 10.1016/j.jpsychires.2009.09.008
Source: PubMed

ABSTRACT Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were initially randomized to IPT or SSRI and then augmented with the second treatment if they did not remit with monotherapy. Assessments included the SCID-I, the SCID-II for DSM-IV diagnoses, the HRSD, the QIDS and the Mood Spectrum Self-Report (MOODS-SR). Seventy-eight (25%) patients reported a history of EPA; 60 (76.9%) were women. Patients with a history of EPA did not differ from those without on HRSD scores at baseline, but showed an earlier age at onset of depression and a longer duration of illness. The two groups differed on several mood spectrum factors, namely: 'depressivemood' (15.6+/-4.9 vs. 13.5+/-5.4; p<0.004), 'psychomotorretardation' (11.7+/-4.5 vs. 9.6+/-4.7; p<0.001), 'drugandillness-relateddepression' (1.3+/-1.3 vs. 0.6+/-1.0; p<0.0001), and 'neurovegetativesymptoms' (8.3+/-2.6 vs. 6.9+/-2.9; p<0.0001). Patients with EPA had also a significantly longer time to remission (89 vs. 67days, log-rank test, p=0.035). The need for augmentation treatment was significantly more frequent among patients with EPA than in those without. The present study suggests that patients with a history of EPA show a subtype of depression characterized by poor treatment response and more severe neurovegetative and psychomotor symptoms.

0 Bookmarks
 · 
108 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Development and characterization of animal models of depression are essential for fully understanding the pathogenesis of depression in humans. We made and analyzed a mouse model exhibiting social deficit and hyperphagia-like behavior using a subchronic and mild social defeat stress (sCSDS) paradigm. The body weight, food and water intake of mice were monitored during a test period, and their behaviors and serum components were analyzed at two stages: immediately after the sCSDS period and 1 month after the sCSDS. The body weight and food intake of defeated mice were significantly higher than control mice at the sCSDS period, and these differences were sustained until 1 month after the sCSDS, whereas the water intake of defeated mice was significantly higher than control mice for the period of sCSDS only. Behavioral analyses revealed that the defeated mice exhibit significant social aversion to unfamiliar mice in a social interaction test and a trend of anxiety-like behavior in an elevated-plus maze test. Possibly due to polydipsia-like symptoms, defeated mice had significantly lower levels of albumin and blood urea nitrogen than control mice immediately after the sCSDS period but not at 1 month after sCSDS. The present study revealed that our sCSDS mice keep much more water in their body than control mice. This study reports the first step toward an understanding of the mechanisms of stress-induced overhydration, over-eating and resultant weight gain.
    Behavioural Brain Research 08/2014; 270. DOI:10.1016/j.bbr.2014.05.040 · 3.39 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Summary Objective: Aim of the study was to examine differences between the course of inpatient treatment in adolescents with different extents of trauma history. Methods: Using multilevel analysis, we investigated the differences between the course of inpatient treatment in adolescents without trauma history, with emotional trauma and complex trauma. Results: Regarding the GSI of the SCL-90-R, patients with trauma history showed significantly more symptom reduction than patients without trauma history. In terms of interpersonal problems (IIP) especially adolescents with emotional trauma seemed to benefit. Conclusions: Especially patients with trauma history benefited from the examined inpatient treatment concept. However, our results also show that the complex traumatized patients required longer treatment duration since they benefited particularly in the last phase of inpatient treatment.
    PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 05/2014; 64:328-335. DOI:10.1055/s-0034-1374594 · 1.02 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We evaluate the association between subtypes of early life stress (ELS; sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect) and psychiatric disorders in adults. The sample was composed of 81 adult psychiatric patients treated at the Day Hospital Unit in Brazil. The patients were assessed using the Mini International Neuropsychiatric Interview according to diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The presence of ELS was confirmed by the Childhood Trauma Questionnaire, which investigates abuse and neglect subtypes. The patients were also evaluated for the severity of psychiatric symptoms through self-report questionnaires. A total of 71.6% of the patients experienced some type of severe ELS compared with 28.4% of the patients without ELS. Of these, 55.5% reported having experienced emotional abuse; 48.1%, physical neglect; 45.7%, emotional neglect; 39.5%, physical abuse; and 27.2%, sexual abuse. Our data showed that, among the ELS subtypes, emotional abuse was positively associated with psychopathology in adults, particularly with mood disorders (p < 0.05). The patients with a history of emotional abuse had higher severity scores in all symptoms, such as depression, hopelessness, suicidal ideation, anxiety, and impulsivity. These data demonstrate the impact of ELS, especially in cases of emotional abuse, as a trigger for psychiatric disorders and indicate that the severity of ELS is associated with severity of psychiatric symptoms. Therefore, further studies are needed to assess the importance of emotional abuse as a risk factor of severe psychopathology in adults.
    Journal of Nervous & Mental Disease 09/2014; 202(11). DOI:10.1097/NMD.0000000000000202 · 1.81 Impact Factor

Full-text (2 Sources)

Download
23 Downloads
Available from
May 28, 2014