title: Impact of childhood adversity on the course and suicidality of depressive disorders: the CRESCEND study.
abstract: OBJECTIVE
  The impact of childhood adversity persists across the life course. This study aimed to investigate the associations of childhood adversity with the course, suicidality, and treatment outcomes of depressive disorders.
  
  
  METHODS
  A total of 919 people with depressive disorders were recruited. Childhood adversities (≤12 years old) were ascertained using a checklist, in sexual abuse, physical abuse by parents, and separation of parents. Various assessment scales were administered at baseline and over 12 weeks of antidepressants treatment.
  
  
  RESULTS
  All three forms of childhood adversity were associated with an increased likelihood of experiencing more current stressful events. Scores on the Beck Depression Inventory and Hamilton Anxiety Rating Scale were significantly higher in participants with a history of sexual abuse. Scores on the Beck Depression Inventory, Hamilton Depression Rating Scale, and Perceived Stress Scale were significantly higher, and scores on the WHO Quality of life instrument were significantly lower in participants with a history of physical abuse by parents. They were more likely to receive augmentation and combination treatment after the initial antidepressant treatment, whereas overall response rates to treatment did not differ. Scores on the Beck Scale for suicide ideation were significantly higher after treatment and/or at baseline in patients with sexual or physical abuse. Physical illness was more prevalent in individuals with physical abuse by parents or separation of parents.
  
  
  CONCLUSIONS
  Depressive patients with a history of childhood adversities had more severe and chronic forms of depression with high suicidality. More intensive treatment with particular clinical attention is indicated for this special population.
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.forename: Hee-Ju
authors.initials: HJ
authors.lastname: Kang
authors.forename: Seon-Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
authors.forename: Jin-Sang
authors.initials: JS
authors.lastname: Yoon
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Jung
authors.forename: Min-Soo
authors.initials: MS
authors.lastname: Lee
authors.forename: Hyeon-Woo
authors.initials: HW
authors.lastname: Yim
authors.forename: Tae-Youn
authors.initials: TY
authors.lastname: Jun
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002650:Child Abuse, Sexual / Q000523:psychology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology*; D004243:Divorce / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D056910:Republic of Korea; D013406:Suicide, Attempted / Q000523:psychology*
chemical_list: D000928:Antidepressive Agents
keywords: childhood adversity; depression; physical abuse; sexual abuse; suicidality