| Background:Childhood trauma widespread exists both at home and abroad,which is a public health issue has attacted much attention.It was well researched in developed countries.It has been confirmed that there was a close association between childhood trauma and major depression in many previous studies.Childhood trauma affects not only the incidence of depression but also the characteristics of the disease,including cognitive impairment,treatment resistance,recurrences,chronicity and increased risk of suicide.Domestic researches in this field was later than abroad.Currently,Researches on the Relationship between Childhood trauma and depression,suicidal ideation,cognitive impairment and social support are not many.Objectives:(1)To investigate the prevalence of childhood trauma among patients with major depression and normal controls.(2)To know the relationship between childhood trauma and the severity of depression,suicidal ideation,neurocognitive function and social support.(3)To evaluate the intermediary effect of severity of depression between childhood trauma and suicidal ideation,neurocognitive function.(4)To assess the adjustment effect of social support between childhood trauma and severity of depression,suicidal ideation and neurocognitive function.Methods:35 cases of patients with major depression were enrolled in this study from Guangzhou Brain Hospital and 26 non-psychogenia,age and gender-equated normal controls were voluntarily recruited from community in this research from May 2014 to May 2015.All participants were standardized interviewed by two attending psychiatrists using Diagnostic and Statistical Manual of Mental Disorders-IV(DSMIV)axis I disorder clinical interview.To evaluate the depressive symptoms of the subjects,Hamilton Depression Rating Scale(HAMD)was measured by attending psychiatrist,combining Self-rating Depression Scale(SDS)was assessed.Childhood Trauma Questionnaire(CTQ),Self-rating Ideation of Suicide Scale(SIOSS),Social Support Scale(SSRS)were evaluated.Symbol Digit Memory Test(SDMT),Digit Span Test(DST),Trail Making Test(TMT)were assessed by Psychometrician to measure the cognitive function of the two groups.Results:(1)Out of 35 depressive cases,22 cases(62.9%)were found with a history of Childhood Emotional Neglect(CEN),19 cases(54.3%)with Childhood Physical Neglect(CPN),6 cases(17.1%)with Childhood Emotional Abuse(CEA),7 cases(20.0%)with Childhood Physical Abuse(CPA),2 cases(5.7%)with Childhood Sexual Abuse(CSA).In 26 cases of normal controls,2 cases(7.7%)were found with Childhood Emotional Neglect(CEN),6 cases(23.1%)with Childhood Physical Neglect(CPN),1 cases(3.8%)with Childhood Emotional Abuse(CEA),0 cases(0%)with Childhood Physical Abuse(CPA),0 cases(0%)with Childhood Sexual Abuse(CSA).In the depression group,there were 20 cases(57.1%)were found with at least two subtypes of childhood trauma,8 cases(22.9%)were with three or more subtypes of childhood trauma,4 cases(11.4%)with four or more subtypes of childhood trauma.(2)Pearson correlation analysis was used.Significant positive correlation was found between Childhood Trauma score and Suicidal Ideation score(r=0.425,p=0.001),Hamilton Depression score(r=0.401 p=0.003).Significant negative correlation was found between childhood trauma score and Social Support score(r=-0.565,p=0.000),Objective Support(r=-0.378,p=0.003),Subjective Support(r=-0.488,p=0.000)and Utilization Degree of Support(r=-0.385,p=0.002).Significant positive correlation was found between Hamilton Depression score and Suicidal Ideation score(r=0.793,p=0.000).Significant negative correlation was found between Hamilton Depression score and Social Support score(r=-0.436,p=0.001),Subjective Support(r=-0.468,p=0.000),Utilization Degree of Support(r=-0.343,p=0.012).Significant linear negative correlation was found between Digit Symbol score and Physical Neglect score(r=-0.394,p=0.003),Sexual Abuse(r=-0.287,p=0.032)and the numbers of subtypes of childhood trauma(r=-0.349,p=0.008).(3)Further to validate the Mediation Effect Model,stepwise regression test was carried out.Firstly,linear regression test was carried out with Suicidal Ideation total score as the dependent variable and Childhood Trauma score as the independent variable,the regression coefficient was 0.425,the P value was 0.001,that showed statistical significance.Then the next linear regression step was carried out with Hamilton depression score as the dependent variable and Childhood Trauma score as the independent variable,the regression coefficient was 0.401,the P value was 0.003,which also showed statistically significant.The third linear regression step with the Suicidal Ideation total score as the dependent variable and both the Childhood Trauma score and Hamilton Depression score as the independent variables,the regression coefficient of Hamilton depression score was 0.747,the P value was 0.000,with statistical significance,while the regression coefficient of childhood trauma score was 0.117,P value was 0.211,without statistical significance.That meant the severity of depression showed intermediary effect between Childhood Trauma and Suicidal Ideation.Mediation Effect Model,stepwise regression test was carried out subsequently,depression was found no intermediary effect between CPN score and SDMT score.(4)According to the Regulation Effect Model of hierarchical regression analysis test program,the regression coefficient of Hamilton depression score to "Z score of trauma*support" was 0.452,P value was 0.040.it meant the regression equation was established with the Hamilton depression score as the dependent variable and the standard score of multiplication of Child traumatic and Social support as one of the independent variable.It verified that the Social Support was an adjusting role between Childhood Trauma and Hamilton Depression.Continue to use hierarchical regression analysis,results were found that the regression coefficient was 0.755,P value was 0.000,when Suicidal Ideation score as the dependent variable and the standard score of multiplication of Child Traumatic and Social Support as one of the independent variable.It meant the Social Support showed adjusting effect between Childhood Trauma and Suicidal Ideation.The regression coefficient was 0.185,P value was 0.171,when SDMT score as the dependent variable and the standard score of multiplication of physical neglect score and Social support as one of the independent variable.It meant the Social Support did not show an adjusting effect between CPN and SDMT score.Conclusions:(1)Higher prevalence rate of distinct types of childhood trauma were found in patients with major depression compared with the general population,which support the idea that childhood trauma is one of the risk factor of depression.(2)Paralleled,the more serious the childhood trauma,the heavier the depression severity,the higher the risk of suicide,the higher risk of cognitive impairment.(3)Childhood trauma indirectly influenced suicide ideation through influencing depression severity;meanwhile Childhood trauma directly influenced cognitive function not through influencing depression severity.(4)To increase social support could reduce the risk of depression and suicide outcomes among individuals suffering from childhood trauma;But could not change the outcomes of SDMT impairment on individuals suffering from childhood physical neglect. |
