Citation

Johnstone JM, Luty SE, Carter JD, Mulder RT, Frampton CM, Joyce PR. Depress. Anxiety 2009; 26(8): 711-717.

Affiliation

Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand. jeanette.johnstone@otago.ac.nz

Copyright

(Copyright © 2009, John Wiley and Sons)

DOI

10.1002/da.20590

PMID

19544315

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.

Language: en