Psychological trauma, posttraumatic stress disorder and trauma-related depression: A mini-review

Table 1 Characteristics of Type I and Type II trauma

Characteristics	Type I	Type II
Resource	Disaster or accident	Abuse or violence or neglect
Onset	Acute onset	Acute or insidious onset in childhood
Duration	Sudden, transient	Repeated, long-lasting
Outcome	Be healed or develop to Type II	Be scarred or protracted
Manifestation	Re-experience, avoidance, alertness, etc. (take PTSD as an example)	PTSD symptoms, disorders in self-organization, disassociation
Mental disorders	Acute stress disorder, PTSD, adjustment disorder	CPTSD, adjustment disorder, Dissociative/conversive disorder

PTSD: Posttraumatic stress disorder; CPTSD: Complex posttraumatic stress disorder.

Table 2 Studies investigating the therapy on major depressive disorder patients with childhood trauma or recent trauma

Ref.	Study/review	Details	Tools	Results
Nemeroff et al[47], 2003	RCT	681 MDD patients with childhood trauma were assigned to nefazodone, CBASP, or combination	HRSD24	For those with childhood trauma, psychotherapy alone was superior to antidepressant monotherapy
Asarnow et al[52], 2009	RCT	334 youth failed in an adequate SSRI trial were randomized to 12 wk with an alternative SSRI, an alternative SSRI + CBT, venlafaxine, or venlafaxine + CBT	CDRS-R, CGI-I	The CBT or combined treatment was superior to medication alone
Nanni et al[50], 2012	meta-analysis	10 clinical trials of 3098 MDD subjects with childhood trauma were analyzed based on depression course: recurrence or persistence	CIDI, PSE, SCAN, MINI or HAMD	Childhood maltreatment was associated with lack of response to treatment and lack of remission (OR = 1.43, 95%CI: 1.11-1.83)
Williams et al[48], 2016	Cohort study	1008 MDD and 336 healthy controls were treated with escitalopram, sertraline or venlafaxine for 8 wk	QIDS_SR16, HRSD17	Below 7 yr of age predicted poorer outcomes, and 4-7 yr the poorest
Yrondi et al[51], 2019	Cohort study	In 291 TRD patients, 135 (52.7%) were available at 1-year follow-up	QIDS_SR, MADRS	Baseline CTQ scores had a significant influence on remission at 1 year [χ2 (1) = 5.57; P < 0.05]
Christensen et al[6], 2020	Cohort study	61% of subjects (1113/1811) reported trauma history, and were treated with vortioxetine (5-20 mg/d) or placebo for 8 wk	MADRS, CGI-I	Subjects with trauma with placebo were more likely to relapse than with vortioxetine
Menke et al[55], 2021	Cohort study	150 in-patients of MDD were recruited in the 4-wk antidepressant trial, 68 with multiple childhood trauma (i.e. ≥ 3) and 59 with ≥ 3 severe recent life events	HRSD21	Severe recent life events were associated with a poor response to antidepressants (F = 7.456; df = 1; P = 0.008), These effects may not be observed with childhood trauma

RCT: Randomized controlled trial; MDD: Major depressive disorder; CBASP: Cognitive behavioral analysis system of psychotherapy; HRSD24: Hamilton rating scale for depression-24 items; SSRI: Selective serotonin reuptake inhibitor; CBT: Cognitive-behavioral therapy; CDRS-R: Children depression rating scale-revised; CGI-I: Clinical global impression–improvement; CIDI-C: Composite international diagnostic interview-core version; PSE: Present state examination; SCAN: Schedules for clinical assessment in neuropsychiatry; MINI: The MINI-international neuropsychiatric interview; HAMD: Hamilton depressive scale; OR: Odds ratio; 95%CI: 95% confidence interval; QIDS_SR16: The 16-item self-report versions of the quick inventory of depressive symptomatology; HRSD17: Hamilton rating scale for depression-17 items; TRD: Treatment-resistant depression; QIDS_SR: Self-report versions of the quick inventory of depressive symptomatology; MADRS: The Montgomery-Asberg depression rating scale; CTQ: The Childhood trauma questionnaire; HRSD21: Hamilton rating scale for depression-21 items.