Relationship Between Prognosis And Childhood Trauma Experiences In Adolescents With Depression:A Cohort Study

Objective:Major depressive disorder(MDD)is a common,severe,and recurrent condition,and adolescent depression is one of the leading causes of suicidal ideation and behavior in adolescents.As an essential factor in the occurrence and development of adolescent depression,childhood trauma may also have a specific predictive effect on the responsiveness of antidepressant treatment and play a particular guiding role in the treatment of depression in adolescents.Therefore,this study aims to explore the relationship between childhood trauma and the prognosis of adolescent depression patients,and provide some theoretical guidance for the clinical treatment of adolescent depression.Methods:This study is a cohort study.Patients were screened from the psychological counseling outpatient or inpatient wards of Chaohu Hospital,Anhui Medical University from January 2021 to November 2021.We conducted a 26-week follow-up survey on 100 patients,and 74 patients finally completed the follow-up.A self-administered questionnaire was used to capture general sociodemographic information about the patients.The Hamilton Rating Scale for Depression(HAMD),the Childhood Trauma Questionnaire(CTQ),the Insomnia Severity Index Scale(ISI),and the Positive and Negative Suicide Ideation Scale(PANSI)were used to assess the patients’ clinical symptoms.Patients were then reassessed for depressive symptoms using the HAMD scale at eight weeks and twenty-six weeks of treatment,and those with a HAMD reduction rate of ≥50%were categorized as the symptomatic remission group,and those with a reduction rate of<50%were categorized as the non-remission group.Patients in the remission and non-remission groups were then statistically analyzed for demographic and clinical data.Results:1.The prevalence of emotional abuse was 52.0%,physical abuse was 20.0%,sexual abuse was 11.0%,emotional neglect was 61.0%,and physical neglect was 62.0%among adolescents with MDD.2.At eight weeks of follow-up,there were statistical differences between the remission and non-remission groups in age at onset,total CTQ score,emotional abuse factor score,emotional neglect factor score,physical neglect factor score,and PANSI score.Twenty-six weeks later,there were statistical differences between the two groups in the total CTQ score,emotional abuse factor score,physical abuse factor score,sexual abuse factor score,emotional neglect factor score,physical neglect factor score,and PANSI score.3.We correlated the HAMD reduction rate with demographic and clinical data,it was found that the HAMD reduction rate was positively correlated with education level and age of onset.It was negatively correlated with the total CTQ score,emotional abuse factor score,sexual abuse factor score,and emotional neglect factor score.4.Logistic regression analysis showed that having a traumatic childhood experience,especially emotional abuse or neglect(p<0.05),was a risk factor for poorer prognosis in adolescent depression.Conclusion:This study was a longitudinal study of the prognosis of 74 adolescent patients with MDD at eight weeks and twenty-six weeks,and its relationship with childhood trauma.The results showed that having experienced childhood trauma,especially emotional abuse or neglect,was a risk factor for poorer prognosis in adolescent depression.It suggests that society,schools,and families should pay more attention to preventing traumatic childhood events,providing necessary emotional support and assistance to adolescents,and creating a good learning and living environment,which may help to improve the clinical cure rate of adolescent depression patients.