Treatment significantly improved symptoms in people with mental disorders and childhood trauma

September 23, 2022

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In individuals with major depressive disorder and childhood trauma, symptoms improved significantly after drug and psychotherapy treatments, regardless of severity, according to a study published in Lancet Psychiatry.

“In patients with a history of childhood trauma, depressive disorders, including major depressive disorder, are characterized by earlier onset, greater frequency, more comorbidity, and poorer responses to psychotherapy or pharmacotherapy,” Erica KuzminskiteAnd the Ms, A doctoral student in the department of psychiatry at Vrije University in the Netherlands and colleagues wrote.

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Kuzminskate and fellow researchers in the Childhood Trauma Meta-Analysis Group examined whether individuals with major depressive disorder — including chronic forms of depression, and a reported history of childhood trauma — had more severe symptoms before treatment, and unfavorable treatment outcomes after active treatments. and were less likely to benefit from active treatments relative to the control condition, compared with depressed individuals without childhood trauma.

They conducted a meta-analysis, searching PubMed, PsycINFO, and Embase from November 2013 to March 2020, as well as randomized clinical trials (RCTs) for full text identified from several sources (1966 through 2016-2019) to identify articles in English. Of a total of 10,505 publications, 54 trials met the inclusion criteria, of which 29 (20 randomized controlled trials and nine open trials) contributed data to a maximum of 6,830 participants aged 18–85 years. The primary outcome of the analysis was the change in depression severity from baseline to the end of the acute treatment phase, expressed as a standard effect size. Meta-analyses were performed via random effects models.

The results showed that 4,268 out of 6,830 patients with severe depressive disorder reported a history of childhood trauma. Despite having more severe depression at baseline (0.202; 95% CI, 0.145 to 0.258), patients with childhood trauma benefited from similarly effective treatment as patients without a history of childhood trauma (treatment effect difference between groups, 0.016 95% CI, -0.094 to 0.125), with no significant difference in active treatment effects (versus control condition) between individuals with or without childhood trauma (childhood trauma, 0.605; 95% CI, 0.294 to 0.916; no Childhood trauma; 0.178; 95% CI, -0.195 to 0.552), and similar dropout rates (RR, 1.063; 95% CI, 0.945 to 1.195).

The researchers also found that the data did not differ significantly by type of childhood trauma, study design, depression diagnosis, method of assessment of childhood trauma, study quality, year, type or length of treatment, but did vary by country.

To improve interventions and outcomes for individuals with childhood trauma, comprehensive and collaborative research is necessary to examine the long-term outcomes of treatment, residual symptoms after treatment, and the mechanisms by which childhood trauma exerts its long-term effects. “