Sandra Scheuer1, Nicole Wiggert2, Tanja Maria Brückl3, Yvonne Awaloff3, Manfred Uhr3, Susanne Lucae3, Stefan Kloiber4, Florian Holsboer5, Marcus Ising3, Frank H Wilhelm6. 1. Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, Germany. Electronic address: info@psychologie-scheuer.de. 2. Department of Psychology, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Hellbrunnerstraße 34, 5020 Salzburg, Austria; Medizinische Hochschule Brandenburg, Theodor Fontane, Fehrbelliner Straße 38, 16816 Neuruppin. 3. Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, Germany. 4. Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada; Centre for Addiction and Mental Health, 100 Stokes St., Toronto, ON, M6J 1H4, Canada. 5. Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, Germany; Current address: HMNC GmbH, Maximilianstraße 34, 80539 Munich, Germany. 6. Department of Psychology, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Hellbrunnerstraße 34, 5020 Salzburg, Austria.
Abstract
BACKGROUND: Traumatic experiences during childhood are considered a major risk factor for depression in adulthood. Childhood trauma may induce physiological dysregulation with long-term effects of increased allostatic load until adulthood, which may lead to depression. Thus, our aim was to investigate whether allostatic load - which represents a multi-system measure of physiological dysregulation - mediates the association between childhood trauma and adult depression. METHODS: The study sample consisted of 324 depressed inpatients participating in the Munich Antidepressant Response Signature (MARS) project and 261 mentally healthy control participants. The mediation analysis using a case-control approach included childhood trauma, i.e., physical and sexual abuse, as predictor variables and an allostatic load index comprised of 12 stress-related biomarkers as mediator. Age and sex were included as covariates. RESULTS: Mediation analyses revealed that the influence of physical abuse, but not sexual abuse, during childhood on depression in adulthood was mediated by allostatic load. This effect was moderated by age: particularly young (18-42 years) and middle-aged (43-54 years) adults with a history of physical abuse during childhood exhibited high allostatic load, which in turn was associated with increased rates of depression, but this was not the case for older participants (55-81 years). CONCLUSIONS: Results support the theoretical assumption of allostatic load mediating the effect of physical abuse during childhood on depression in adulthood. This predominantly holds for younger participants, while depression in older participants was independent of physical abuse and allostatic load. The effect of sexual abuse on depression, however, was not mediated by allostatic load. Identifying allostatic load biomarkers prospectively in the developmental course of depression is an important target for future research.
BACKGROUND: Traumatic experiences during childhood are considered a major risk factor for depression in adulthood. Childhood trauma may induce physiological dysregulation with long-term effects of increased allostatic load until adulthood, which may lead to depression. Thus, our aim was to investigate whether allostatic load - which represents a multi-system measure of physiological dysregulation - mediates the association between childhood trauma and adult depression. METHODS: The study sample consisted of 324 depressed inpatients participating in the Munich Antidepressant Response Signature (MARS) project and 261 mentally healthy control participants. The mediation analysis using a case-control approach included childhood trauma, i.e., physical and sexual abuse, as predictor variables and an allostatic load index comprised of 12 stress-related biomarkers as mediator. Age and sex were included as covariates. RESULTS: Mediation analyses revealed that the influence of physical abuse, but not sexual abuse, during childhood on depression in adulthood was mediated by allostatic load. This effect was moderated by age: particularly young (18-42 years) and middle-aged (43-54 years) adults with a history of physical abuse during childhood exhibited high allostatic load, which in turn was associated with increased rates of depression, but this was not the case for older participants (55-81 years). CONCLUSIONS: Results support the theoretical assumption of allostatic load mediating the effect of physical abuse during childhood on depression in adulthood. This predominantly holds for younger participants, while depression in older participants was independent of physical abuse and allostatic load. The effect of sexual abuse on depression, however, was not mediated by allostatic load. Identifying allostatic load biomarkers prospectively in the developmental course of depression is an important target for future research.
Authors: Dawn Kingston; Muhammad K Mughal; Muhammad Arshad; Igor Kovalchuk; Gerlinde A S Metz; Katherine Wynne-Edwards; Suzanne King; Shui Jiang; Lynne Postovit; Abdul Wajid; Sheila McDonald; Donna M Slater; Suzanne C Tough; Katherine Aitchison; Paul Arnold Journal: Front Psychiatry Date: 2019-10-31 Impact factor: 4.157