A two-year observational study of 110 patients has revealed that  early life trauma may affect the structure of the brain in a way that makes clinical depression more likely to be severe and recurrent.

 

According to  sciencedaily.com,  in the study published by  The Lancet Psychiatry Journal, participants between  ages 18  and  60 years were  admitted to hospital following a diagnosis of major depression.

 

Dr Nils Opel,  lead researcher of the study, said, “Our findings add further weight to the notion that patients with clinical depression who were mistreated as children are clinically distinct from non-maltreated patients with the same diagnosis.

 

“Given the impact of the insular cortex on brain functions such as emotional awareness, it is possible that the changes we saw make patients less responsive to conventional treatments. “Future psychiatric research should, therefore, explore how our findings could be translated into special attention, care, and treatment that could improve patient outcomes.”

 

The researchers divided patients into those who did not experience any relapse  in the two-year period and those who experienced at least one additional depressive episode.

 

They wrote, “Of the 75 patients in the relapse sample, 48 had experienced one additional episode, seven reported two episodes, and six experienced three episodes, while 14 had a remission period of less than two months and could, therefore, be regarded as having chronic depression. Childhood maltreatment was significantly associated with depression relapse.”

 

The researchers noted that the limitation of the study was that experiences  of childhood maltreatment and depressive symptoms were assessed retrospectively and therefore could be subject to recall bias.

 

Dr Lianne Schmaal, from the University of Melbourne, Australia, said, “A key remaining question is whether, in the sample investigated in the study by Opel and colleagues, the observed reduction in the insular surface area reflects a stable trait or normalises over time with remission of depression.

 

“This study is an important contribution to our knowledge of mechanisms that confer risk for depression relapse. A better understanding of these mechanisms is crucial to develop or improve risk-adapted interventions for people susceptible to a worse long-term clinical outcome.”