Effects of persisting emotional impact from child abuse and norepinephrine transporter genetic variation on antidepressant efficacy in major depression: a pilot study.
OBJECTIVE
Previous studies suggest child abuse and serotonergic polymorphism influence depression susceptibility and antidepressant efficacy. Polymorphisms of the norepinephrine transporter (NET) may also be involved. Research in the area is possibly clouded by under reporting of abuse in researcher trials.


METHODS
Adults (n=51) with major depressive disorder has 8 weeks treatment with escitalopram or venlafaxine. Abuse history was obtained, the ongoing emotional impact of which was measured with the 15-item impact of event scale (IES-15). The 17-item Hamilton Depression Rating Scale (HDRS) was applied serially. Two NET polymorphisms (rs2242446 and rs5569) were assayed, blinded to HDRS ratings and abuse history.


RESULTS
No subjects reporting abuse with high impact in adulthood (IES-15 ≥26, n=12) remitted; whereas 77% reporting low impact (IES-15 <26; n=26) remitted (p<0.001). Subjects reporting high impact abuse (n=12) had a 50-fold (95% confidence interval=4.85-514.6) greater odds of carrying rs2242446-TT genotype, but the small sample size leaves this finding vulnerable to type I error.


CONCLUSIONS
The level of persisting impact of child abuse appears relevant to antidepressant efficacy, with susceptibility to such possibly being influence by NET rs2242446 polymorphism. Larger studies may be merited to expand on this pilot level finding given potential for biomarker utility.
IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia.
Ajeet Bhagat
AB
Singh
Departments of Psychiatry, Parkville, VIC, Australia.|Departments of General Practice, Parkville, VIC, Australia.|Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorne, VIC, Australia.|Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.
Chad A
CA
Bousman
Departments of Psychiatry, Parkville, VIC, Australia.
Chee Hong
CH
Ng
Healthscope Pathology, Clayton, VIC, Australia.
Keith
K
Byron
IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia.|Departments of Psychiatry, Parkville, VIC, Australia.|Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.|Centre for Youth Mental Health, Orygen Youth Health Research Centre, Parkville, VIC, Australia.
Michael
M
Berk
Abuse; Antidepressants; Child