Impact of childhood trauma on the efficacy of escitalopram for the treatment of adult depression

Objective To explore the effect of childhood trauma on escitalopram treatment of adult depression. Methods There were 68 adult patients with major depression disorder recruited.All patients were assessed with Childhood Trauma Questionnaire (CTQ) and given 8 weeks of standardized treatment with escitalopram.Beck Depression Inventory (BDI) and HAMD-17 were assessed at the end of the 2nd, 4th and 8th week respectively.The changes of BDI score and HAMD-17 score in patients with different CTQ factors were observed. Results (1) The overall effect of intervention was 25.0% at the end of 4th week and 45.6% at the end of 8th week.The total effective rate was 94.1%.At the end of 4th week, there was no significant difference in the clinical recovery rate between the positive group(19.5%) and the negative group(33.3%)(χ2=1.66, P>0.05). There was no significant difference in clinical recovery between the two groups at the end of 8th week(positive group : 39.0%, negative group : 55.6%, χ2=1.79, P>0.05). (2) The total score reduction rate of HAMD-17((46.26±24.79)%, (58.39±23.25)%) and BDI((51.63±16.03)%, (66.28±18.05)%) at the end of 4th week and the total score reduction rate of BDI at the end of 8th week ((59.13±15.42)%, (68.50±20.91)%)in the positive group were lower than those in the negative group (P<0.05). (3) Except for sexual abuse, there was a significant negative correlation between CTQ scores and the reduction rate of BDI scores at end of 4th and 8th week(r=-0.46--0.06, P<0.05). Conclusion Childhood trauma has adverse effects on the efficacy of escitalopram in the treatment of adult depression. Key words: Childhood trauma; Depression; Escitalopram; Efficacy