期刊
DEPRESSION AND ANXIETY
卷 26, 期 8, 页码 711-717出版社
WILEY-LISS
DOI: 10.1002/da.20590
关键词
depression; Parental Bonding Instrument (PBI); childhood adversity; treatment predictors; abuse; neglect
资金
- Health Research Council of New Zealand
- Lottery Health
- Eli Lilly
- University of Otago
- Mental Health Division of Canterbury Health
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. Depression and Anxiety 26.711-717, 2009. (C) 2009 Wiley-Liss, Inc.
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