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- Title
The structural equation analysis of childhood abuse, adult stressful life events, and temperaments in major depressive disorders and their influence on refractoriness.
- Authors
Hiroyuki Toda; Takeshi Inoue; Tomoya Tsunoda; Yukiei Nakai; Masaaki Tanichi; Teppei Tanaka; Naoki Hashimoto; Yasuya Nakato; Shin Nakagawa; Yuji Kitaichi; Nobuyuki Mitsui; Shuken Boku; Hajime Tanabe; Masashi Nibuya; Aihide Yoshino; Ichiro Kusumi
- Abstract
Background: Previous studies have shown the interaction between heredity and childhood stress or life events on the pathogenesis of a major depressive disorder (MDD). In this study, we tested our hypothesis that childhood abuse, affective temperaments, and adult stressful life events interact and influence the diagnosis of MDD. Patients and methods: A total of 170 healthy controls and 98 MDD patients were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9), the Life Experiences Survey, the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire, and the Child Abuse and Trauma Scale (CATS). The data were analyzed with univariate analysis, multivariable analysis, and structural equation modeling. Results: The neglect scores of the CATS indirectly predicted the diagnosis of MDD through cyclothymic and anxious temperament scores of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire in the structural equation modeling. Two temperaments - cyclothymic and anxious - directly predicted the diagnosis of MDD. The validity of this result was supported by the results of the stepwise multivariate logistic regression analysis as follows: three factors - neglect, cyclothymic, and anxious temperaments - were significant predictors of MDD. Neglect and the total CATS scores were also predictors of remission vs treatment-resistance in MDD patients independently of depressive symptoms. Limitations: The sample size was small for the comparison between the remission and treatment-resistant groups in MDD patients in multivariable analysis. Conclusion: This study suggests that childhood abuse, especially neglect, indirectly predicted the diagnosis of MDD through increased affective temperaments. The important role as a mediator of affective temperaments in the effect of childhood abuse on MDD was suggested.
- Subjects
CHILD abuse; DEPRESSION in children; PSYCHOLOGICAL stress; MENTAL health; DISEASES
- Publication
Neuropsychiatric Disease & Treatment, 2015, Vol 11, p2079
- ISSN
1176-6328
- Publication type
Article
- DOI
10.2147/NDT.S82236