Depresión adulta y experiencias infantiles adversas: evidencia de un subtipo depresivo complejo en consultantes de la Atención Primaria en Chile

Resumen

Background: Traumatic experiences during childhood may influence the development of mental disorders during adulthood. Aim: To determine clinical and psychosocial variables that are associated with a higher frequency of adverse childhood experiences (ACE) in patients who consult for depression in Primary Health Care clinics in Chile. Material and methods: A socio-demographic interview, the mini international neuropsychiatric interview (MINI), a screening for ACE, a questionnaire for partner violence (PV), the Life Experiences Survey (LES) and the Hamilton Rating Scale for Depression (HRDS) were applied to 394 patients with major depression (87% women). Results: Eighty two percent of patients had experienced at least one ACE and 43 % of them reported three or more. Positive correlations were observed between the number of ACE and severity of depressive symptoms (r=0.19; p< 0.01), psychiatric comorbidities (r= 0.23; p<0.01), partner violence events (r= 0.31; p <0.01), vital stressful events (r=0.12; p<0.01), number of depressive episodes (r=0.16; p< 0.01), duration of the longer depressive episode (r=0.12; p<0.05) and suicidal tendency according to HDRS (r=0.16; p<0.01). An inverse correlation was observed between frequency of ACE and age at the first depressive episode (r= -0.12; p<0.05). Conclusions: These data are consistent with the hypothesis that early trauma is associated with more severe and complex depressive episodes during adulthood.