Does Childhood Trauma Reduce Subsequent Response to Antidepressants?

Major depressive disorder (MDD) is highly heterogeneous, and the disease remits with antidepressants in <50% of patients. In an international study funded by a personalized-medicine company, researchers examined antidepressant effectiveness, prevalence of childhood trauma (an established vulnerability to MDD), and impact of trauma “load” on antidepressant response.

Participants were 1008 adults with moderate-to-severe, nonpsychotic MDD (recurrent in 90%). Among the patient exclusions were lifetime psychosis, bipolar disorder, eating disorder, post-traumatic stress disorder, and axis II disorders. Patients were randomized to escitalopram, sertraline, or venlafaxine extended-release (XR).

Compared with 336 healthy controls, a higher percentage …