Relationship between childhood physical abuse and clinical severity of treatment-resistant depression in a geriatric population.

We assessed the correlation between childhood maltreatment (CM) and severity of depression in an elderly unipolar Treatment-Resistant Depression (TRD) sample. Patients were enrolled from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centres. Our sample included 96 patients (33% of the overall cohort) aged 60 years or above, with a mean age of 67.2 (SD = 5.7). The majority of the patients were female (62.5%). The Montgomery and Asberg Depression Rating Scale (MADRS) and Quick Inventory Depression Scale-Self Report (QIDS-SR) mean scores were high, 28.2 (SD = 7.49) [MADRS score range: 0-60; moderate severity≥20, high severity≥35] and 16.5 (SD = 4.94) [IDS-SR score range: 0-27; moderate severity≥11, high severity≥16], respectively. Mean self-esteem scores were 22.47 (SD = 6.26) [range 0-30]. In an age- and sex-adjusted model, we found a positive correlation between childhood trauma (CTQ scores) and depressive symptom severity [MADRS (β = 0.274; p = 0.07) and QIDS-SR (β = 0.302; p = 0.005) scores]. We detected a statistically significant correlation between physical abuse and depressive symptom severity [MADRS (β = 0.304; p = 0.03) and QIDS-SR (β = 0.362; p = 0.005) scores]. We did not observe any significant correlation between other types of trauma and depressive symptom severity. We showed that self-esteem (Rosenberg scale) mediated the effect of physical abuse (PA) on the intensity of depressive symptoms [MADRS: b = 0.318, 95% BCa C.I. [0.07, 0.62]; QIDS-SR: b = 0.177, 95% BCa C.I. [0.04, 0.37]]. Preacher & Kelly's Kappa Squared values of 19.1% (k2 = 0.191) and 16% (k2 = 0.16), respectively for the two scales, indicate a moderate effect. To our knowledge, this is the first study conducted in a geriatric TRD population documenting an association between childhood trauma (mainly relating to PA) and the intensity of depressive symptoms.

Déclaration de conflit d'intérêts

Antoine Yrondi received speaker’s honoraria (AstraZeneca, Janssen, Lundbeck, Otsuka, Servier), and carried out clinical studies in relation to the development of a medicine (Janssen, Lundbeck) unrelated to this work. Christophe Arbus received honoraria (Janssen, Lundbeck, Otsuka) and carried out clinical studies in relation to the development of a medicine (Janssen). Olivier Doumy received honoraria from Lilly, Astra-Zeneca, Janssen, Servier and Lundbeck. Jean Baptiste Genty received speaker’s honoraria from Servier. Pierre Michel Llorca received grants, honoraria, and consulting fees from Allergan, Gedeon Richter, Janssen-Cilag, Lundbeck, Otsuka, Recordati, Sanofi-Aventis and Teva. Raphael Rachieri received speaker’s honoraria from Janssen Cilag. Ludovic Samalin received grants, honoraria, and consulting fees from Janssen-Cilag, Lundbeck, and Otsuka. Florian Stephan received honoraria from Otsuka. Guillaume Vaiva received speaker’s honoraria from Otsula/Lundbeck (Annual participation at the reception day for new professors of psychiatry). Emmanuel Haffen: acted in an advisory capacity, carried out clinical studies in relation to the development of a medicine, received personal research, study or travel allowances, gave presentations at meetings, and received remuneration for input from the following pharmaceutical organisations: AstraZeneca, BMS, Cellgene, Euthérapie - Servier, Janssen, Elli Lilly, Lundbeck, LivaNova, Otsuka, Pfizer and Sanofi. He also held a managerial position at the FondaMental Foundation (Créteil) and the French Association of Biological Psychiatry and Neuropsychopharmacology. Wissam El-Hage has received speaker’s honoraria from Chugai, Eisai, Lundbeck, Janssen-Cilag, Otsuka, and UCB unrelated to this work. Bruno Aouizerate received speaker’s honoraria and a travel allowance from Lundbeck, Janssen-Cilag, and Eli Lilly. He has served on the advisory board of Janssen-Cilag. Our compeing interest does not alter our adherence to PLOS ONE policies on sharing data and materials.