Quilty Lena C, Marshe Victoria, Lobo Daniela S S, Harkness Kate L, Müller Daniel J, Bagby R Michael
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Neuropsychobiology. 2016;74(2):78-83. doi: 10.1159/000453549. Epub 2017 Jan 7.
Childhood abuse is a powerful prognostic indicator in adults with major depressive disorder (MDD) and is associated with numerous biological risk factors for depression. The purpose of this investigation was to explore if antidepressant medication affinity for the serotonin transporter moderates the association between childhood abuse and treatment response.
Our sample included 52 outpatients with MDD who had received up to 26 weeks of pharmacotherapy, stratifying antidepressant medications with a high versus a low affinity for the serotonin transporter. Patients completed the Hamilton Rating Scale for Depression, Beck Depression Inventory II, Home Environment Questionnaire, and Ontario Health Supplement: Child Abuse and Trauma Scale to assess depression and childhood abuse.
Medication class moderated the link between 3 indices of childhood abuse and treatment response such that higher levels of childhood abuse were associated with higher levels of depression severity after treatment only in those patients receiving antidepressant medications with a weak affinity for the serotonin transporter.
This pilot study suggested that prolonged exposure to stress during childhood may result in biological vulnerabilities for depression, which may in turn be differentially targeted by pharmacological agents which target serotonin to a greater or lesser degree.
童年期受虐是成年重度抑郁症（MDD）患者的一个重要预后指标，且与众多抑郁症的生物学风险因素相关。本研究旨在探讨抗抑郁药物对5-羟色胺转运体的亲和力是否会调节童年期受虐与治疗反应之间的关联。
我们的样本包括52名接受了长达26周药物治疗的MDD门诊患者，将抗抑郁药物分为对5-羟色胺转运体亲和力高和低的两类。患者完成了汉密尔顿抑郁评定量表、贝克抑郁量表第二版、家庭环境问卷以及安大略省健康补充问卷：儿童虐待与创伤量表，以评估抑郁情况和童年期受虐经历。
药物类别调节了童年期受虐的3项指标与治疗反应之间的联系，即只有在那些接受了对5-羟色胺转运体亲和力弱的抗抑郁药物治疗的患者中，童年期受虐程度越高，治疗后抑郁严重程度越高。
这项初步研究表明，童年期长期暴露于压力之下可能会导致抑郁症的生物学易感性，而针对5-羟色胺程度不同的药物可能会对其产生不同的靶向作用。
