Abstract
BackgroundChildhood adversity may lead to depressive relapse through its long-lasting influence on stress sensitivity. In line with the stress sensitization hypothesis, minor (daily) stress is associated with depressive relapse. Therefore, we examine the impact of childhood adversity on daily stress and its predictive value on prospectively assessed depressive symptoms in recurrently depressed patients.MethodDaily stress was assessed in recurrently depressed adult patients, enrolled into two randomized trials while remitted. The reported intensity and frequency of dependent and independent daily stress was assessed at baseline. Independent stress is externally generated, for example an accident happening to a friend, while dependent stress is internally generated, for example getting into a fight with a neighbor. Hierarchical regression analyses were performed with childhood adversity, independent and dependent daily stress as predictor variables of prospectively measured depressive symptoms after three months of follow-up (n = 138).ResultsWe found that childhood adversity was not significantly associated with a higher frequency and intensity of daily stress. The intensity of both independent and dependent daily stress was predictive of depressive symptom levels at follow-up (unadjusted models respectively: B = 0.47, t = 2.05, p = 0.041, 95% CI = 0.02–0.92; B = 0.29, t = 2.20, p = 0.028, 95% CI = 0.03–0.55). No associations were found between childhood adversity and depressive symptoms at follow-up.ConclusionNo evidence was found supporting stress sensitization due to the experience of childhood adversity in this recurrently depressed but remitted patient group. Nevertheless, our research indicates that daily stress might be a target for preventive treatment.Trial RegistrationTrial A: Nederlands Trial Register NTR1907 Trial B: Nederlands Trial Register NTR2503
Highlights
Major Depressive Disorder (MDD) is a highly recurrent disease with reported relapse and recurrence rates that range from 50– 90% [1,2]
We found that childhood adversity was not significantly associated with a higher frequency and intensity of daily stress
The intensity of both independent and dependent daily stress was predictive of depressive symptom levels at followup
Summary
Major Depressive Disorder (MDD) is a highly recurrent disease with reported relapse and recurrence rates that range from 50– 90% [1,2]. Each depressive episode heightens the risk of additional relapses and recurrences [1,3,4,5]. Sexual abuse and emotional neglect seem to be associated with a poor prognosis of depression, and appear as independent determinants of chronicity of the disorder [10,11,12,13]. Knowledge on how childhood adversity leads to a poor prognosis of depression would provide insight into the causal processes and might help tailor treatment. Childhood adversity may lead to depressive relapse through its long-lasting influence on stress sensitivity. In line with the stress sensitization hypothesis, minor (daily) stress is associated with depressive relapse. We examine the impact of childhood adversity on daily stress and its predictive value on prospectively assessed depressive symptoms in recurrently depressed patients
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