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Childhood maltreatment linked to long-term depression

New study by King's College strengthens the argument for early intervention

People who have experienced maltreatment as children are twice as likely to develop both multiple and long-lasting depressive episodes as those without a history of childhood maltreatment, according to a new study. The research, led by a team at King's College London Institute of Psychiatry, also found that maltreated individuals are more likely to respond poorly to pharmacological and psychological treatment for depression. 

The results, published in the American Journal of Psychiatry, have emerged from a combined analysis of 16 epidemiological studies involving more than 20,000 participants and of 10 clinical trials involving more than 3,000 participants. 

Dr Andrea Danese, senior investigator of the study at King's said:

'Identifying those at risk of multiple and long-lasting depressive episodes is crucial from a public health perspective. The results indicate that childhood maltreatment is associated both with an increased risk of developing recurrent and persistent episodes of depression, and with an increased risk of responding poorly to treatment. 

'Therefore prevention and early therapeutic interventions targeting childhood maltreatment could prove vital in helping prevent the major health burden owing to depression. Knowing that individuals with a history of maltreatment won't respond as well to treatment may also be valuable for clinicians in determining patients' prognosis.' 

Dr Danese continued:

'The biological abnormalities associated with childhood maltreatment could potentially explain why individuals with a history of maltreatment respond poorly to treatment for depression.' 

Dr Andrew McCulloch, Chief Executive of the Mental Health Foundation, responded to the study: 

'We hope that this research will raise awareness of the links between mental ill-health and childhood experiences of poverty, abuse, poor parenting and bereavement.

'Different treatment responses need to be developed for individuals who have experienced childhood maltreatment as such experiences can impact on an individual's biological and psychological development, placing them at a higher risk of developing multiple and long-lasting mental health conditions.

'More research into intervention methods for this group is needed, and more resources are required to support existing treatments and to make them more specific to an individual's needs. This time of economic uncertainty should not be used as an excuse to ignore these asks, but instead to pursue them, as investing in mental health interventions and treatments now will prevent additional costs in the future generated by the worsening of people's mental health if these problems are not tackled.'

The research was supported by the MRC Social, Genetic & Developmental Psychiatry Centre (SGDP), and the Department of Child and Adolescent Psychiatry, both at the Institute of Psychiatry, King's College London. The authors are funded by the National Alliance for Research on Schizophrenia and Depression (NARSAD/Brain and Behavior Research Fund, USA), the Italian Ministry of University and Scientific Research, and the European Commission.