The association of childhood trauma and personality disorders with chronic depression: A cross-sectional study in depressed outpatients.
J Clin Psychiatry
; 76(6): e794-801, 2015 Jun.
Article
in En
| MEDLINE
| ID: mdl-26132688
ABSTRACT
OBJECTIVE:
Chronic depression has often been associated with childhood trauma. There may, however, be an interaction between personality pathology, childhood trauma, and chronic depression. This interaction has not yet been studied.METHOD:
This retrospective analysis is based on 279 patients contacted for a randomized trial in an outpatient psychotherapy center over a period of 18 months from 2010 to 2012. Current diagnoses of a personality disorder and presence of chronic depression were systematically assessed using the Structured Clinical Interview for DSM-IV. Retrospective reports of childhood trauma were collected using the short form of the Childhood Trauma Questionnaire (CTQ-SF). DSM-IV-defined chronic depression was the primary outcome. The association between chronic depression, childhood trauma, and personality disorders was analyzed using correlations. Variables that had at least a small effect on correlation analysis were entered into a series of logistic regression analyses to determine the predictors of chronic depression and the moderating effect of childhood trauma.RESULTS:
The presence of avoidant personality disorder, but no CTQ-SF scale, was associated with the chronicity of depression (odds ratio [OR] = 2.20, P = .015). The emotional abuse subscale of the CTQ-SF did, however, correlate with avoidant personality disorder (OR = 1.15, P = .000). The level of emotional abuse had a moderating effect on the effect of avoidant personality disorder on the presence of chronic depression (OR = 1.08, P = .004). Patients who did not suffer from avoidant personality disorder had a decreased rate of chronic depression if they retrospectively reported more severe levels of emotional abuse (18.9% vs 39.7%, respectively).CONCLUSIONS:
The presence of avoidant personality pathology may interact with the effect of childhood trauma in the development of chronic depression. This has to be confirmed in a prospective study. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT01226238.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Personality Disorders
/
Dysthymic Disorder
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Depressive Disorder, Major
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Adult Survivors of Child Abuse
Type of study:
Observational_studies
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Prevalence_studies
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Prognostic_studies
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Qualitative_research
/
Risk_factors_studies
Limits:
Adult
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Female
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Humans
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Male
Language:
En
Journal:
J Clin Psychiatry
Year:
2015
Document type:
Article
Affiliation country:
Germany