Functional Correlates of childhood maltreatment and symptom severity during affective theory of mind tasks in chronic depression.
Among multiple etiological factors of depressive disorders, childhood maltreatment (CM) gains increasing attention as it confers susceptibility for depression and predisposes to chronicity. CM assumedly inhibits social-cognitive development, entailing interactional problems as observed in chronic depression (CD), especially in affective theory of mind (ToM). However, the extent of CM among CD patients varies notably as does the severity of depressive symptoms. We tested whether the extent of CM or depressive symptoms correlates with affective ToM functions in CD patients. Regional brain activation measured by functional magnetic resonance imaging during an affective ToM task was tested for correlation with CM, assessed by the Childhood Trauma Questionnaire (CTQ), and symptom severity, assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS), in 25 unmedicated CD patients (mean age 41.52, SD 11.13). Amygdala activation during affective ToM correlated positively with CTQ total scores, while (para)hippocampal response correlated negatively with MADRS scores. Our findings suggest that differential amygdala activation in affective ToM in CD is substantially modulated by previous CM and not by the pathophysiological equivalents of current depressive symptoms. This illustrates the amygdala's role in the mediation of CM effects. The negative correlation of differential (para)hippocampal activation and depressive symptom severity indicates reduced integration of interactional experiences during depressive states.
Department of General Psychiatry, University Hospital of Heidelberg, Vossstrasse 4, 69115 Heidelberg, Germany. Electronic address: Charlotte.Hentze@med.uni-heidelberg.de.
Charlotte
C
Hentze
Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Universitaetsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: Henrik.Walter@charite.de.
Henrik
H
Walter
Department of Psychiatry and Psychotherapy, University Medical Centre Freiburg im Breisgau, Hauptstrasse 5, 79104 Freiburg, Germany; Psychiatric University Clinics Basel, Wilhelm Klein-Strasse 27, 4012 Basel, Switzerland. Electronic address: elisabeth.schramm@uniklinik-freiburg.de.
Elisabeth
E
Schramm
Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany. Electronic address: Sarah.Drost@ukb.uni-bonn.de.
Sarah
S
Drost
Department of Psychiatry, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany. Electronic address: Dieter.Schoepf@ukb.uni-bonn.de.
Dieter
D
Schoepf
Department of Psychiatry and Psychotherapy, University Medical Centre Freiburg im Breisgau, Hauptstrasse 5, 79104 Freiburg, Germany. Electronic address: thomas.fangmeier@uniklinik-freiburg.de.
Thomas
T
Fangmeier
Department of General Psychiatry, University Hospital of Heidelberg, Vossstrasse 4, 69115 Heidelberg, Germany. Electronic address: Margarete.Mattern@med.uni-heidelberg.de.
Margarete
M
Mattern
Department of Psychiatry and Psychotherapy, University Medical Centre Freiburg im Breisgau, Hauptstrasse 5, 79104 Freiburg, Germany. Electronic address: claus.normann@uniklinik-freiburg.de.
Claus
C
Normann
Psychology School at the Fresenius University of Applied Sciences Berlin, Jägerstraße 32, 10117 Berlin, Germany. Electronic address: Ingo.Zobel@hs-fresenius.de.
Ingo
I
Zobel
Department of General Psychiatry, University Hospital of Heidelberg, Vossstrasse 4, 69115 Heidelberg, Germany. Electronic address: Knut.Schnell@med.uni-heidelberg.de.
Knut
K
Schnell
D000328:Adult; D000679:Amygdala / Q000502:physiology; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000523:psychology*; D002908:Chronic Disease; D003863:Depression / Q000000981:diagnostic imaging* / Q000523:psychology*; D005260:Female; D006624:Hippocampus / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D056345:Theory of Mind / Q000502:physiology*
Amygdala; Early trauma; Hippocampus; Mentalizing; Persistent depressive disorder; Social cognition; fMRI