Childhood trauma associated with smaller hippocampal volume in women with major depression.
OBJECTIVE
Smaller hippocampal volume has been reported only in some but not all studies of unipolar major depressive disorder. Severe stress early in life has also been associated with smaller hippocampal volume and with persistent changes in the hypothalamic-pituitary-adrenal axis. However, prior hippocampal morphometric studies in depressed patients have neither reported nor controlled for a history of early childhood trauma. In this study, the volumes of the hippocampus and of control brain regions were measured in depressed women with and without childhood abuse and in healthy nonabused comparison subjects.


METHODS
Study participants were 32 women with current unipolar major depressive disorder-21 with a history of prepubertal physical and/or sexual abuse and 11 without a history of prepubertal abuse-and 14 healthy nonabused female volunteers. The volumes of the whole hippocampus, temporal lobe, and whole brain were measured on coronal MRI scans by a single rater who was blind to the subjects' diagnoses.


RESULTS
The depressed subjects with childhood abuse had an 18% smaller mean left hippocampal volume than the nonabused depressed subjects and a 15% smaller mean left hippocampal volume than the healthy subjects. Right hippocampal volume was similar across the three groups. The right and left hippocampal volumes in the depressed women without abuse were similar to those in the healthy subjects.


CONCLUSIONS
A smaller hippocampal volume in adult women with major depressive disorder was observed exclusively in those who had a history of severe and prolonged physical and/or sexual abuse in childhood. An unreported history of childhood abuse in depressed subjects could in part explain the inconsistencies in hippocampal volume findings in prior studies in major depressive disorder.
Vythilingam
Meena
M
Mood and Anxiety Disorders Program, National Institute of Mental Health, 15K North Drive, Room 111, MSC 2670, Bethesda, MD 20892-2670, USA. meena.vythi@nih.gov
Heim
Christine
C
Newport
Jeffrey
J
Miller
Andrew H
AH
Anderson
Eric
E
Bronen
Richard
R
Brummer
Marijn
M
Staib
Lawrence
L
Vermetten
Eric
E
Charney
Dennis S
DS
Nemeroff
Charles B
CB
Bremner
J Douglas
JD
D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006624:Hippocampus / Q000033:anatomy & histology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology*; D013702:Temporal Lobe / Q000033:anatomy & histology*