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Is Childhood Adversity Related to Endogenous Depression in Women?

Women with endogenous depression -- which is thought to have strong biologic roots -- experienced high levels of adversity as children.

Study results have suggested that childhood adversity is associated with nonendogenous depression (i.e., depressed moods that are reactive to environmental events) but not with endogenous depression (defined by vegetative signs, absence of precipitating stressors, and relative lack of reactivity to environmental events). To assess the relation between these depression subtypes and adverse childhood experiences through age 17, researchers interviewed 76 community-dwelling women who were experiencing major depressive episodes (mean age, 37).

Thirty-one women met research criteria for endogenous depression. Severe physical abuse, sexual abuse, parental antipathy and neglect, and both high and lax levels of parental supervision and discipline were all associated with endogenous -- but not with nonendogenous -- depression. Poor parental care (which included parental antipathy and neglect) and sexual abuse were particularly predictive of endogenous symptoms.

Comment: The authors theorize that their findings differ from previous ones because the present study distinguished levels of severity in childhood adversity. These findings underscore the concept that negative childhood experiences may increase vulnerability to psychiatric disorders that are thought to have strong biologic roots. Still, one could hypothesize that individuals with severe depression are prone to recall negative early life histories. To eliminate that possibility and to tease apart the relative contributions of genetics and adverse environments in producing endogenous depression, researchers must conduct prospective studies of a suitable population of children. For example, children growing up with endogenously depressed parents may carry along their parents' genetic vulnerabilities and may be more likely to experience adverse early experiences resulting from growing up with seriously depressed parents. This speculation is consistent with increasing evidence that adverse early events affect secretion of corticosteroid-releasing factor, which may in turn increase vulnerability to subsequent depression. Future studies should also include males to ascertain whether these findings hold true for both sexes. For clinicians, these findings imply that biologic treatments for endogenous depression are often only part of what patients need.

— Joel Yager, MD

Published in Journal Watch Psychiatry March 21, 2002

Citation(s):

Harkness KL and Monroe SM. Childhood adversity and the endogenous versus nonendogenous distinction in women with major depression. Am J Psychiatry 2002 Mar; 159:387-93.

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