Abstract
Background: Childhood neglect and abuse are recognized as risk factors for depression, but are not often studied as predictors of treatment response in depression. Methods: Clinically depressed outpatients (n = 195) were asked about childhood experiences before beginning a randomized antidepressant trial with either fluoxetine or nortriptyline. Three treatment outcomes were measured: Adequate trial, six-week response and two months sustained recovery. Results: Patients reporting low paternal care (paternal neglect), as measured by the Parental Bonding Instrument (PBI), were less likely to complete an adequate six-week trial of medication. Patients who reported high maternal protection (maternal overprotection) on the PBI had poorer treatment response in the short-term at six weeks, and longer term, for two months of sustained recovery. However, abuse, whether sexual, physical, or psychological in nature, did not predict treatment response. Conclusions: The experience of having a neglectful father or an overprotective mother was more predictive of response to treatment for depression than abuse, suggesting that the quality of ongoing intra-familial relationships has a greater impact on treatment outcomes for depression than experiences of discrete abuse in childhood.
Original language | English (US) |
---|---|
Pages (from-to) | 711-717 |
Number of pages | 7 |
Journal | Depression and Anxiety |
Volume | 26 |
Issue number | 8 |
DOIs | |
State | Published - Aug 2009 |
Externally published | Yes |
Keywords
- Abuse
- Childhood adversity
- Depression
- Neglect
- Parental Bonding Instrument (PBI)
- Treatment predictors
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health