Early adversity in chronic depression: clinical correlates and response to pharmacotherapy

• DOI: 10.1002/da.20577
• Publication Date: 2009-05-11T13:50:43Z
• Authors: Daniel N. Klein; Bruce A. Arnow; Jennifer L. Barkin; Frank Dowling; James H. Kocsis; Andrew C. Leon; Rachel Manber; Barbara O. Rothbaum; Madhukar H. Trivedi; Stephen R. Wisnie...
• Keywords: Depression; Pharmacotherapy; Dysfunctional family; Major depressive episode

There is growing evidence suggesting that early adversity may be a marker for distinct pathway to major depressive disorder (MDD). We examined associations between childhood and broad variety of clinical characteristics response pharmacotherapy in large sample patients with chronic forms MDD.Subjects included 808 MDD (chronic MDD, double depression, or recurrent incomplete recovery episodes total continuous duration >2 years) who were enrolled 12-week open-label trial algorithm-guided pharmacotherapy. Baseline assessments semi-structured diagnostic interview, clinician- self-rated measures symptoms, social functioning, depressotypic cognitions, personality traits, adversity. Patients re-evaluated every 2 weeks.A longer illness; earlier onset; greater number episodes, symptom severity, functional impairment, suicidality, comorbid anxiety disorder; higher levels dysfunctional attitudes self-criticism each associated multiple A history maternal overcontrol, paternal abuse, indifference, sexual an index clinically significant abuse predicted lower probability remission. Among completing the trial, 32% compared 44% without such history, achieved remission.These findings indicate especially form less responsive antidepressant