[Relationship between childhood trauma and depressive symptoms in adolescents with major depressive episodes and the mediating roles of perceived stress and abnormal brain structural development].

Objective

To explore the relationship between childhood trauma and depressive symptoms in adolescents with major depressive episodes (MDE), and the mediating roles of perceived stress and abnormal brain structural development.

Methods

Adolescents with MDE treated at the Early Intervention Department of Nanjing Brain Hospital from September 2021 to August 2024 were retrospectively enrolled. Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ) and patients were categorized into groups with or without childhood trauma. Depressive symptom severity was evaluated with the Patient Health Questionnaire-9 (PHQ-9), and perceived stress was measured using the Perceived Stress Scale (PSS). Functional MRI scans were performed to acquire neuroimaging data. Individual deviations in cortical thickness, relative to healthy population norms, were compared between the two groups. Multiple linear regression was used to examine associations between different types of childhood trauma and depressive symptoms. Mediation analyses were conducted to explore whether perceived stress or cortical thickness deviations mediated the relationship between childhood trauma and depressive symptoms.

Results

A total of 300 patients were included. The childhood trauma group included 51 males and 103 females [mean age (15.1±1.4) years], and the non-trauma group included 49 males and 97 females [mean age (15.2±1.4) years], with no significant differences in age, sex, or diagnosis (all P>0.05). The childhood trauma group exhibited significantly higher PHQ-9, PSS, and CTQ scores compared to the non-trauma group (all P<0.05), and showed more pronounced negative deviations in cortical thickness in the left caudal middle frontal region (false discovery rate correction-corrected P=0.027). Across all patients, multiple linear regression analysis indicated that emotional abuse (β=0.672，95%CI：0.447-0.897) and sexual abuse (β=0.637，95%CI：0.201-1.070) were associated with PHQ-9 scores. Mediation analysis revealed that perceived stress mediated the relationships between emotional abuse [β=0.424 (95%CI: 0.310-0.540), effect size=58.89%, P<0.001] and sexual abuse [β=0.489 (95%CI: 0.151-0.864), effect size=45.74%, P=0.007] with PHQ-9 scores, respectively. Additionally, cortical thickness deviation in the left caudal middle frontal region also mediated the association between emotional abuse and PHQ-9 scores [β=0.029 (95%CI: 0.003-0.070), effect size=4.03%, P=0.026].

Conclusion

Specific types of childhood trauma are associated with depressive symptoms in adolescents with MDE, and this association may be partly explained through the mediating roles of perceived stress and abnormal brain structural development.