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

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

Research output: Contribution to journalArticlepeer-review

Abstract

Background: While childhood maltreatment (CMT) is associated with higher rates of chronicity and recurrence in depression, whether CMT results in poorer outcomes with antidepressant medication remains unclear. Methods: We performed secondary analyses with data from the large, representative, multisite trial Combining Medications to Enhance Depression Outcomes (CO-MED). CO-MED was a randomized, single-blinded, placebo-controlled study with 665 individuals (663 assessed for CMT) with chronic and/or recurrent Major Depressive Disorder (MDD). CMT was determined by a brief self-reported questionnaire assessing the four types of CMT defined by the Centers for Disease Control and Prevention: sexual abuse, emotional abuse, physical abuse, and neglect. Repeated measures and logistic regression analyses were used. Results: Individuals with CMT did not have a differential improvement of depressive symptoms when compared to those without CMT (adjusted p=.203 for continuous analysis; adjusted p=.320 for remission rates). Neither type of antidepressant medication (adjusted p=.302) nor the age at which CMT occurred (adjusted p=.509) affected depressive symptom outcomes. There was no difference in functional improvement between individuals with and without CMT (adjusted p=.228). A history of CMT was associated with greater antidepressant side effects (p=.009). Limitations: This study investigated treatment-seeking individuals with chronic and/or recurrent MDD. Intensity and duration of CMT were not assessed. Conclusion: In a sample of treatment-seeking outpatients with chronic and/or recurrent MDD, a history of CMT was not associated with differential symptomatic or functional response to pharmacological treatment. However, those with CMT reported greater antidepressant side effect burden.

Original languageEnglish (US)
Pages (from-to)39-45
Number of pages7
JournalJournal of affective disorders
Volume291
DOIs
StatePublished - Aug 1 2021

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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