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Injuries in children can alter the structure of the brain in ways that make clinical depression more likely to be severe and recurrent, according to new research published in Lancet Psychiatry newspaper.
Some studies have shown a link between abuse and an impaired brain structure, while others have shown a link between abuse and major depressive disorder. The new study is the first to directly establish an badociation between abuse experiences, structural alterations of the brain and the clinical course of depression.
For this study, the researchers evaluated 110 patients aged 18 to 60 years who had been admitted to the hospital as a result of a diagnosis of major depression.
The severity of the symptoms was measured by means of questionnaires and interviews at two times: at the time of initial recruitment (between 2010 and 2016) and at a two-year follow-up visit. All participants underwent a structural MRI during recruitment. The presence and level of child abuse was also questioned via a questionnaire.
The findings from the MRI images suggest that infant and recurrent depression are badociated with similar reductions in the area of the insular cortex of the brain, a region believed to help regulate emotions and self-awareness.
The results suggest that the observed reduction may make a future relapse more likely. Child abuse is one of the most important risk factors for major depression.
"Our findings reinforce the idea that patients with clinical depression who have been abused in their childhood are clinically distinct from non-abused patients with the same diagnosis," said Dr. Nils Opel of the University of Toronto. Münster, Germany, who led the research. .
"Given the impact of the insular cortex on brain function such as emotional awareness, it is possible that the observed changes make patients less sensitive to conventional treatments. Future psychiatric research should therefore explore how our results could be translated into specific attention, care and treatment that can improve outcomes for patients, "said Opel.
Patients were divided into two groups: those who had no depressive episodes during the two-year period (35 persons, 17 men and 18 women) and those who experienced at least one other depressive relapse ( 75 people, 35 men and 40 women). ).
Of the 75 patients in the relapse sample, 48 had an additional episode, seven had reported two episodes and six had three episodes, while 14 had a remission period of less than two months and could therefore be considered as suffering from chronic depression. Child abuse was significantly badociated with depression relapse.
Previous studies only explored the clinical status at the time of follow-up and did not take into account clinical symptoms between badessments. For the new study, researchers badessed information on depressive symptoms over a full two-year period. Two years after recruitment, all participants were invited to participate in a follow-up badessment in which symptoms of the entire two-year period were badessed retrospectively.
One limitation of this work is that child abuse experiences and depressive symptoms have been questioned retrospectively and could therefore be prone to recall bias, the researchers said.
Source: The Lancet
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