Childhood Maltreatment and Differential Treatment Response and Recurrence in Adult Major Depressive Disorder

Autor/inn/en	Harkness, Kate L.; Bagby, R. Michael; Kennedy, Sidney H.
Titel	Childhood Maltreatment and Differential Treatment Response and Recurrence in Adult Major Depressive Disorder
Quelle	In: Journal of Consulting and Clinical Psychology, 80 (2012) 3, S.342-353 (12 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0022-006X
DOI	10.1037/a0027665
Schlagwörter	Outcomes of Treatment; Rating Scales; Children; Antisocial Behavior; Depression (Psychology); Foreign Countries; Psychotherapy; Psychiatry; Patients; Child Abuse; Cognitive Restructuring; Behavior Modification; Measures (Individuals); Scores; Drug Therapy; Interviews; Sexual Abuse; Adults; Canada; Hamilton Rating Scale for Depression + Suchen Sie Ihr Suchwort? Rating-Skala; Child; Kind; Kinder; Ausland; Psychotherapie; Psychiatrie; Patient; Abuse of children; Abuse; Children; Kindesmissbrauch; Missbrauch; Behaviour modification; Verhaltensänderung; Messdaten; Interviewing; Interviewtechnik; Sexueller Missbrauch; Kanada
Abstract	Objective: A substantial number of patients with major depressive disorder (MDD) do not respond to treatment, and recurrence rates remain high. The purpose of this study was to examine a history of severe childhood abuse as a moderator of response following a 16-week acute treatment trial, and of recurrence over a 12-month follow-up. Method: Participants included 203 adult outpatients with MDD (129 women; age 18-60). The design was a 16-week single-center randomized, open label trial of interpersonal psychotherapy, cognitive-behavioral therapy, or antidepressant medication, with a 12-month naturalistic follow-up, conducted at a university psychiatry center in Canada. The main outcome measure was Hamilton Depression Rating Scale scores at treatment end point. Childhood maltreatment was assessed at the completion of treatment using an interview-based contextual measure of childhood physical, sexual, and emotional abuse. Multiple imputation was adopted to estimate missing values. Results: Patients with severe maltreatment were significantly less likely to respond to interpersonal psychotherapy than to cognitive-behavioral therapy or medication (OR = 3.61), whereas no differences among treatments were found in those with no history of maltreatment (ORs less than 1.50). Furthermore, maltreatment significantly predicted a shorter time to recurrence over follow-up across treatment conditions (OR = 3.04). These findings were replicated in the sample with complete case data. Conclusions: Patients with a history of childhood abuse may benefit more from antidepressant medication or cognitive-behavioral therapy than from interpersonal psychotherapy. However, these patients remain vulnerable to recurrence regardless of treatment modality. (Contains 3 footnotes, 2 figures and 2 tables.) (As Provided).
Anmerkungen	American Psychological Association. Journals Department, 750 First Street NE, Washington, DC 20002-4242. Tel: 800-374-2721; Tel: 202-336-5510; Fax: 202-336-5502; e-mail: order@apa.org; Web site: http://www.apa.org/publications
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10