The contribution of early adverse stress to complex and severe depression in depressed outpatients

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dc.contributor.authorGloger, Sergio
dc.contributor.authorVohringer, Paul A.
dc.contributor.authorMartinez, Pablo
dc.contributor.authorVictoria Chacon, M.
dc.contributor.authorCaceres, Cristian
dc.contributor.authorDiez de Medina, Dante
dc.contributor.authorCottin, Marianne
dc.contributor.authorBehn, Alex
dc.date.accessioned2025-01-20T23:53:56Z
dc.date.available2025-01-20T23:53:56Z
dc.date.issued2021
dc.description.abstractBackground 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.
dc.description.abstractMethods 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.
dc.description.abstractResults 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).
dc.description.abstractConclusions 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.
dc.fuente.origenWOS
dc.identifier.doi10.1002/da.23144
dc.identifier.eissn1520-6394
dc.identifier.issn1091-4269
dc.identifier.urihttps://doi.org/10.1002/da.23144
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/95008
dc.identifier.wosidWOS:000620708700001
dc.issue.numero4
dc.language.isoen
dc.pagina.final438
dc.pagina.inicio431
dc.revistaDepression and anxiety
dc.rightsacceso restringido
dc.subjectaffective disorders
dc.subjectchild abuse
dc.subjectdepressive disorder
dc.subjectpopulation attributable risk
dc.subjectpsychotic
dc.subjectsuicidal ideation
dc.subjecttreatment resistant
dc.subject.ods03 Good Health and Well-being
dc.subject.ods05 Gender Equality
dc.subject.odspa03 Salud y bienestar
dc.subject.odspa05 Igualdad de género
dc.titleThe contribution of early adverse stress to complex and severe depression in depressed outpatients
dc.typeartículo
dc.volumen38
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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