Magazine article Clinical Psychiatry News

Fallout from Early Trauma Might Hinge on Genes: Some Patients Get Depression, Others PTSD

Magazine article Clinical Psychiatry News

Fallout from Early Trauma Might Hinge on Genes: Some Patients Get Depression, Others PTSD

Article excerpt

KOLOA, HAWAII -- Genetic factors might play a role in determining who gets posttraumatic stress disorder after trauma and who gets depression, according to two studies.

In addition, increasing evidence suggests that child abuse and neglect are associated with an increased risk for mood disorders and anxiety disorders such as PTSD, Dr. Charles B. Nemeroff said at the annual meeting of the American College of Psychiatrists.

To investigate the relationship between a history of childhood abuse and depression, Dr. Nemeroff and his colleagues relied on interviews and DNA samples from two groups. The primary participant group (n = 422) was drawn from people waiting at the general medical clinic of Grady Memorial Hospital, a public hospital in Atlanta. An independent group (n = 199) of subjects from the women's mental health center at Emory University in Atlanta provided additional supportive data (Arch. Gen. Psychiatry 2008; 65: 190-200).

The primary group, which was "highly indigent," was 97% African American and had substantial histories of trauma. The "supportive" group at Emory was 88% white and had a higher socioeconomic status, said Dr. Nemeroff, Reunette W. Harris Professor and chairman of the department of psychiatry and behavioral sciences, Emory University.

Beck Depression Inventory scores were used to measure depression in the primary group. The women in the supportive sample had been evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders to assess history of major depressive disorder.

The investigators ascertained levels of early trauma in both groups with the Childhood Trauma Questionnaire. Referring in his presentation to results from the subjects in the primary participant group, Dr. Ne-meroff noted that he and his colleagues found "a dose-dependent--not surprising--increase in depression severity as a function of their early childhood abuse." Using DNA samples from the study participants, the investigators then looked at genetic polymorphisms in the corticotropin-releasing hormone receptor 1 (CRHR1) gene.

Corticotropin-releasing factor (CRF) has been reported to be elevated in the cerebrospinal fluid of depressed patients, Dr. Nemeroff said, and CRF has been repeatedly documented to be elevated in patients with PTSD.

The CRF system, he noted, is "the brain system involved largely in regulating stress." The investigators wanted to answer the question of whether CRF is involved in the biology of depression that is related to early-life trauma. …

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