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The contribution of early adverse stress to complex and severe depression in depressed outpatients.
Gloger, Sergio; Vöhringer, Paul A; Martínez, Pablo; Chacón, M Victoria; Cáceres, Cristian; Diez de Medina, Dante; Cottin, Marianne; Behn, Alex.
Afiliação
  • Gloger S; Psicomedica, Clinical & Research Group, Santiago, Chile.
  • Vöhringer PA; Departamento de Psiquiatría y Salud Mental Campus Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
  • Martínez P; Psicomedica, Clinical & Research Group, Santiago, Chile.
  • Chacón MV; Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile.
  • Cáceres C; Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago, Chile.
  • Diez de Medina D; Mood Disorders Program, Tufts Medical Center, Boston, Massachusetts, USA.
  • Cottin M; Department of Psychiatry, Tufts University School of Medicine, Boston, Massachusetts, USA.
  • Behn A; Psicomedica, Clinical & Research Group, Santiago, Chile.
Depress Anxiety ; 38(4): 431-438, 2021 04.
Article em En | MEDLINE | ID: mdl-33621410
BACKGROUND: To assess whether linear effects or threshold effects best describe the association between early adverse stress (EAS) and complex and severe depression (i.e., depression with treatment resistance, psychotic symptoms, and/or suicidal ideation), and to examine the attributable risk of complex and severe depression associated with EAS. METHODS: A cross-sectional study was conducted using deidentified clinical data (on demographics, presence of complex and severe depression, and exposure to seven types of EAS) from 1,013 adults who were seen in an outpatient mental health clinic in Santiago, Chile, for a major depressive episode. Multivariate logistic regressions were fitted to estimate odds ratios (ORs), using a bootstrap approach to compute 95% bias-corrected confidence intervals (95% BC CIs). A detailed examination of the cumulative risk score and calculations of the attributable risk was conducted. RESULTS: Exposure to at least five EASs was reported by 3.6% of the sample. In the multivariate logistic regression models, there was a marked increase in the odds of having complex and severe depression associated with exposure to at least five EASs (OR = 4.24; 95% BC CI: 1.25 to 9.09), according to a threshold effect. The attributable risk of complex and severe depression associated with exposure to at least one EAS was 36.8% (95% BC CI: 17.7 to 55.9). CONCLUSIONS: High levels of EAS distinctively contribute to complex clinical presentations of depression in adulthood. Patients with complex clinical presentations of depression and history of EAS should need a differentiated treatment approach, particularly those having high levels of EAS.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtorno Depressivo Maior Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Depress Anxiety Assunto da revista: PSIQUIATRIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Chile País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transtorno Depressivo Maior Tipo de estudo: Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Depress Anxiety Assunto da revista: PSIQUIATRIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Chile País de publicação: Estados Unidos