Relationship of Suicide Risk with Early Life Stress and Resilience in Patients with Major Depressive Disorder

Kyuhyeong Huh; Won-Jung Choi; Jeong-Ho Seok

doi:10.4306/jknpa.2014.53.6.386

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Huh, Choi, and Seok: Relationship of Suicide Risk with Early Life Stress and Resilience in Patients with Major Depressive Disorder

Original Article

Journal of Korean Neuropsychiatric Association 2014; 53(6): 386-393.

Published online: 30 November 2014

DOI: https://doi.org/10.4306/jknpa.2014.53.6.386

Relationship of Suicide Risk with Early Life Stress and Resilience in Patients with Major Depressive Disorder

Kyuhyeong Huh, MD¹, Won-Jung Choi, MD², Jeong-Ho Seok, MD, PhD^1,³

¹Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.

²Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

³Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.

Address for correspondence: Jeong-Ho Seok, MD, PhD. Department of Psychiatry, Gangnam Serverance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Korea. Tel +82-2-2019-3343, Fax +82-2-3462-4304, johnstein@yuhs.ac

Received 16 July 2014 Revised 19 August 2014 Accepted 1 September 2014

Abstract

Objectives

The aim of this study is to investigate the relationship of suicide risk with early-life stress (ELS) and resilience in patients with major depressive disorder (MDD).

Methods

The participants were 60 patients with MDD and 29 healthy volunteers. Each subject was assessed concerning ELS, resilience factors, suicide ideation, and depressive symptom severity using self-report questionnaires. Mann-Whitney test and stepwise multiple linear regression analyses were performed.

Results

Emotional abuse, physical abuse, neglect, and exposure to inter-parental violence were higher in the patient group than in the control group. Resilience factors were significantly lower in the patient group. In multiple regression analyses, final regression model including physical abuse, neglect, and self-regulation factor was significant explaining 45.6% variance of suicide ideation score.

Conclusion

We found that ELS experiences, particularly exposure to inter-parental violence, might be a significant risk factor for development of depression. In particular, experiences of physical abuse and neglect might increase the risk of suicide in depression but resilience may play a protective role in development of depression and prevention of suicide in depressive patients.

Keywords: Early-life stress, Resilience, Suicide, Major depressive disorder

Figures and Tables

Table 1

Clinical characteristics of the subjects

Values are presented as mean±SD. ^*: Chi-square test for categorical variable and independent t-test for continuous variable were performed p-values less than 0.05 were considered significant. HC : Healthy control group, MDD : Major depressive disorder patient group, SD : Standard deviation

Table 2

Comparison of early life stress profile and resilience factors depending on the major depressive disorder or the presence of ELS

Values are presented as median (25??5% quartile). Mann-Whitney tests were performed. ^*: p-values less than 0.05 were considered significant. HC : Healthy control group, MDD : Major depressive disorder patient group, ELS : Early life stress, IPR : Interpersonal relationship

Table 3

Comparison of early life stress profiles and resilience factors between health control and major depressive disorder groups depending on the presence of ELS

Table 4

Association of suicide risk with early life stress and resilience in MDD

Multiple regression analyses were performed. Dependent variables : Reynolds' Suicide Ideation Questionnaire. Model 1 (R²=0.116, F=25.040), Model 2 (R²=0.400, F=18.310), Model 3 (R²=0.456, F=15.093). MDD : Major depressive disorder patient group

Table 5

Association of suicide risk with early life stress and resilience in MDD with early life stress

Multiple regression analyses were performed. Dependent variables : Reynolds' Suicide Ideation Questionnaire. Model 1 (R²=0.357, F=23.353), Model 2 (R²=0.501, F=20.623), Model 3 (R²=0.572, F=17.796). MDD : Major depressive disorder patient group

Notes

The authors have no financial conflicts of interest.

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