Childhood neglect and abuse as predictors of antidepressant response in adult depression

Jeni Johnstone, Suzanne E. Luty, Janet D. Carter, Roger T. Mulder, Christopher M A Frampton, Peter R. Joyce

Research output: Contribution to journalArticle

35 Scopus citations


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 languageEnglish (US)
Pages (from-to)711-717
Number of pages7
JournalDepression and Anxiety
Issue number8
Publication statusPublished - Aug 1 2009
Externally publishedYes



  • Abuse
  • Childhood adversity
  • Depression
  • Neglect
  • Parental Bonding Instrument (PBI)
  • Treatment predictors

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Johnstone, J., Luty, S. E., Carter, J. D., Mulder, R. T., Frampton, C. M. A., & Joyce, P. R. (2009). Childhood neglect and abuse as predictors of antidepressant response in adult depression. Depression and Anxiety, 26(8), 711-717.