Effects Of Childhood Maltreatment On Severity And Cognitive Functioning In Patients With Major Depressive Disorder

Objective:Based on the repeated neuropsychological state Battery and event-related potential(ERP)N170,the present study included the following three aspects: 1.Differences in clinical symptoms and cognitive function between MDD patients with and without Childhood Abuse(CA);2.The association between childhood abuse and clinical symptoms in MDD;3.To Explore whether different types of childhood abuse and cognitive functioning are risk factors for depressive disorders.To provide data support for clinical research and diagnosis and treatment.Methods:Sixty-five patients with primary untreated MDD were divided into a group with CA(41 patients)and a group without CA(24 patients)according to the Childhood Trauma Questionnaire(CTQ)scale,and 30 healthy controls(HC)were collected at the same time.The 17-item Hamilton depression scale(HAMD-17),childhood trauma questionnaire(CTQ),Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)were administered to each of the three groups of subjects,and N170 wave amplitude and latency were collected from the subjects.Statistical analysis was performed using SPSS26 statistical software.Comparisons between the three groups were made using the χ~2test for count data(gender)and the Kruskal-Wallis H test or ANOVA for comparisons of measurement data(age,years of education,HAMD-17 total and factor scores,RBANS scale total and factor scores and N170 indicators).The correlations of CTQ total and factor scores with HAMD-17 total and factor scores,and N170 latency and wave amplitude in MDD patients were analysed by partial correlation using age,gender,and years of education as covariates.The presence or absence of depressive disorder(none =0,presence = 1)was used as the independent variable,and the RBANS total score and its factor score,the N170 values of each indicator,the CTQ factor scores and demographic factors were used as independent variables in a multi-factor logistic stepwise regression analysis to understand the possible risk factors for depressive disorders.Test level α=0.05,two-sided test.Results:1.There was a significant difference in education years between the three groups(P<0.05),with the CA group having fewer than the control group.Clinical symptom comparison:the total HAMD-17 score and factor scores(except weight factor)were less in the healthy controls than in the two case groups,and the weight factor score was lesser than in the CA group,with differences that were significant(P< 0.05).2.The RBANS was compared between the three groups: the attention factor score in the group without CA was poorer than in the healthy controls,and the result was statistically significant(P<0.05).The total RBANS score was poorer in both case groups than in the healthy controls,and the result was statistically significant(P<0.05).Comparison of N170 indexes among three groups: the interaction between groups and electrode points had no significant effect on N170 amplitude(F interaction = 0.119,P interaction = 0.054)and latency(F interaction = 1.948,P interaction = 0.073)(P> 0.05),the main effects of group and electrode point on N170 amplitude and latency were not statistically significant(P > 0.05).3.Analysis of the correlation between CTQ and HAMD-17 in the case group: the total HAMD-17 score in the case group was positively correlated with the total CTQ score(r=0.347,P=0.006),emotional abuse(r=0.271,P=0.033),physical abuse(r=0.411,P=0.001)factor scores,and the anxiety/somatization(r=0.211,P= 0.099),cognitive impairment(r=0.343,P=0.006),and sleep disturbance(r=0.289,P=0.023)factor scores were all positively correlated with the physical abuse factor.4.P7 electrode site N170 wave amplitude was positively correlated with total CTQ score(r=0.263,P=0.039),and PO7 electrode site N170 latency was positively correlated with physical neglect factor score(r=0.311,P=0.014)and total CTQ score(r=0.264,P=0.038).5.Analysis of risk factors for depressive disorders: emotional maltreatment,somatic maltreatment,emotional neglect,and somatic neglect may be risk risk factors for depressive disorders;total RBANS score,immediate memory,and attention factor are protective factors for depressive disorders.Of these,each increase in the emotional neglect factor score was associated with a(1.136-1)fold increase in the likelihood of developing a depressive disorder;each increase in the total RBANS score was associated with a(1-0.990)fold decrease in the likelihood of developing a depressive disorder.Conclusion:1.Multi-domain cognitive impairment exists in MDD patients;2.Childhood maltreatment is a risk factor for depressive disorder and is positively correlated with the severity of depression in MDD patients.3.Childhood abuse experience is positively correlated with N170 amplitude and latency in MDD patients.