The Association Between Childhood Trauma and Selective Serotonin Reuptake Inhibitor Treatment Outcomes in Adult Patients With Major Depressive Disorder

Abstract

Objective The relationship between childhood trauma (CT) and the outcomes of selective serotonin reuptake inhibitor (SSRI) treatment for major depressive disorder (MDD) remains uncertain. The objective of this study is to investigate the overall association between CT and treatment outcomes in patients with MDD and the associations of different CT subtypes with the treatment outcomes of various MDD symptom dimensions.Methods A post hoc analysis of 285 adult patients with MDD from a multicenter, prospective study in China. Patients who completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and 8-week SSRI treatment were included. Depressive symptoms were evaluated using the 17-item Hamilton Rating Scale for Depression (HRSD-17) at baseline and at 2, 4, and 8 weeks. The primary outcome was defined as the percentage reduction in the total HRSD-17 score at the 8th week. The secondary outcomes included the percentage reduction in anhedonia and insomnia, derived from the HRSD-17. Linear regression analyses were conducted to evaluate the associations between the CTQ-SF score and treatment outcomes.Results Emotional neglect (EN) was associated with lower percentage reductions in HRSD-17 scores (β=-3.035, p=0.019), anhedonia (β=-4.227, p=0.044) and insomnia (β=-7.054, p=0.045) at 8 weeks. The total CTQ-SF score and other subscale scores were not significantly associated with treatment outcomes.Conclusion EN was associated with poorer SSRI treatment outcomes in MDD patients, with less improvement in overall depressive symptoms and anhedonia and insomnia in particular. EN should be prioritized in MDD treatment.