Childhood Maltreatment Predicts Unfavorable Course of Illness and Treatment Outcome in Depression: A Meta-Analysis
Childhood Maltreatment Predicts Unfavorable Course of Illness and Treatment Outcome in Depression: A Meta-Analysis
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DOI：
10.1176/appi.ajp.2011.11020335
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发表时间：
2012-02-01
影响因子：
17.7
通讯作者：
Danese, Andrea
中科院分区：
文献类型：
--
作者：
Nanni, Valentina;Uher, Rudolf;Danese, Andrea
目的：证据表明，儿童虐待不仅会对抑郁症的终生风险产生负面影响，而且还会影响抑郁症的临床相关度量，例如疾病和治疗结果。作者进行了第一次荟萃分析，以研究儿童虐待与这些临床上相关的抑郁措施之间的关系。方法：作者在Medline，Psycinfo，Psycinfo和embase中进行了搜索，并检查了儿童虐待与疾病过程（即。 ，复发或持久性）以及在2010年12月31日之前出现在文献中的抑郁症的治疗结果。在抑郁发作的次数。持久性是根据当前抑郁发作的持续时间定义的。根据反应（基线降低50％的抑郁严重程度降低）或缓解（抑郁严重程度降低以下是预定义的临床显着性水平）的定义。参与者）提出，儿童虐待与发生复发和持续性抑郁发作的风险升高有关（赔率比率= 2.27，95％置信区间[CI] = 1.80-2.87）。对10项临床试验（3,098名参与者）进行的荟萃分析表明，儿童虐待与抑郁症治疗期间缺乏反应或缓解有关（赔率= 1.43，95％CI = 1.11-1.83）。元回归分析表明，结果并未受到出版偏见的显着影响，结果措施的选择，包括患病率或发病率样本，研究质量，样本年龄或终身抑郁症患病率。抑郁症的疾病和治疗结果。
Objectives: Evidence suggests that childhood maltreatment may negatively affect not only the lifetime risk of depression but also clinically relevant measures of depression, such as course of illness and treatment outcome. The authors conducted the first meta-analysis to examine the relationship between childhood maltreatment and these clinically relevant measures of depression.Method: The authors conducted searches in MEDLINE, PsycINFO, and Embase for articles examining the association of childhood maltreatment with course of illness (i.e., recurrence or persistence) and with treatment outcome in depression that appeared in the literature before December 31, 2010. Recurrence was defined in terms of number of depressive episodes. Persistence was defined in terms of duration of current depressive episode. Treatment outcome was defined in terms of either a response (a 50% reduction in depression severity rating from baseline) or remission (a decrease in depression severity below a predefined clinical significance level).Results: A meta-analysis of 16 epidemiological studies (23,544 participants) suggested that childhood maltreatment was associated with an elevated risk of developing recurrent and persistent depressive episodes (odds ratio=2.27, 95% confidence interval [CI]=1.80-2.87). A meta-analysis of 10 clinical trials (3,098 participants) revealed that childhood maltreatment was associated with lack of response or remission during treatment for depression (odds ratio=1.43, 95% CI=1.11-1.83). Meta-regression analyses suggested that the results were not significantly affected by publication bias, choice of outcome measure, inclusion of prevalence or incidence samples, study quality, age of the sample, or lifetime prevalence of depression.Conclusions: Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression.