Childhood trauma combined with suicide attempts affects cognitive function and inflammation levels in drug-naive patients with major depressive disorder.

BACKGROUND

Childhood trauma (CT) and suicide attempts (SA) independently associate with cognitive impairment in major depressive disorder (MDD), but their interactive effect and biology mechanisms still unknown.

METHODS

We recruited a total of 156 first-episode drug-naïve patients with MDD and 90 healthy controls (HC). Using the Childhood Trauma Questionnaire (CTQ), Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), and Repeatable Battery for Assessment of Neuropsychological Status (RBANS) to assess recruited patients with MDD and HC. And we measured the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), tumor necrosis factor receptor-2 (TNFR2), catalase (CAT), glutathione reductase (GSR) and superoxide dismutase (SOD) in MDD patients using enzyme-linked immunosorbent assay (ELISA).

RESULTS

MDD patients demonstrated significantly lower scores across all cognitive domains compared to HC (p < 0.001). In MDD patients, a significant interaction between CT and SA history was observed for RBANS total scores (p = 0.028), immediate memory (p = 0.045), attention (p = 0.008), and TNF-α levels (p = 0.018), while CT independently affected GSR levels (p = 0.034). Stratifying MDD patients into four subgroups (CT+SA+, CT-SA+, CT+SA-, CT-SA-) revealed that the CT+SA+ group had significantly lower RBANS total scores (p = 0.01) and attention scores (p < 0.001) than other subgroups. TNF-α levels showed no significant differences among four subgroups (p = 0.047).

CONCLUSION

CT and SA may synergistically exacerbate cognitive impairment, especially attention deficit, in drug-naive patients with MDD and may tend to increase TNF-α levels.