The Impact of Trauma History on Acute Treatment Outcomes in Pediatric Major Depressive Disorder

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Title: The Impact of Trauma History on Acute Treatment Outcomes in Pediatric Major Depressive Disorder
Author: Mahoney, Jodi Rae
Abstract: The impact of childhood trauma on depression in youth was examined through a secondary analysis of pooled data from three studies of Major Depressive Disorder (MDD ) in youth . A total of 292 children and adolescents ages 7 to 18 (53 % male , 70 % Caucasian , mean age = 12 .83 ) , received open treatment with fluoxetine for a period of 6 to 12 weeks . Youth were separated into three trauma history groups : no trauma , trauma—no abuse , and abuse . Associations between trauma history and demographic and clinical characteristics of depression were examined . The effects of trauma and abuse history on depression severity and remission rates following acute treatment with fluoxetine were explored using depression severity scores from the Children’s Depressive Rating Scale -Revised (CDRS -R ) and remission status , defined as a score of ≤ 28 on CDRS -R and a Clinical Global Impressions (CGI ) Improvement score of 1 or 2 . Abuse history was associated with older age , older age of depression onset , longer length of illness , and suicidal ideation and behavior at baseline . Abuse history was also associated with some differences in initial depressive symptom profiles among children . The hypothesis that youth with a history of abuse would demonstrate lower remission rates at the end of acute treatment was partially supported . Odds ratios indicated that youth without a history of abuse were twice as likely to have remitted at the end of acute treatment when compared to those with no abuse history . This finding did not remain significant after controlling for the effects of age and family history of depression . No differences were found in depression severity across the acute phase of treatment based on trauma history . Additionally , trauma history was not associated with a difference in youth’s time to achieve remission . Results should be considered in context of small sample sizes and limited assessment of trauma in the current study . These results suggest the importance of thoroughly assessing for trauma history , especially abuse , and considering the impact of these events on youth’s depressive presentation and treatment needs .
URI: http : / /hdl .handle .net /2152 .5 /949
Date: 2011-12-14

Citation

The Impact of Trauma History on Acute Treatment Outcomes in Pediatric Major Depressive Disorder. Graduate School of Biomedical Sciences. Available electronically from http : / /hdl .handle .net /2152 .5 /949 .

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