Childhood neglect and abuse as predictors of antidepressant response in adult depression

Jeanette M. Johnstone, Suzanne E. Luty, Janet D. Carter, Roger T. Mulder, Christopher M.A. Frampton, Peter R. Joyce

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Background: Childhood neglect and abuse are recognized as risk factors for depression, but are not often studied as predictors of treatment response in depression. Methods: Clinically depressed outpatients (n = 195) were asked about childhood experiences before beginning a randomized antidepressant trial with either fluoxetine or nortriptyline. Three treatment outcomes were measured: Adequate trial, six-week response and two months sustained recovery. Results: Patients reporting low paternal care (paternal neglect), as measured by the Parental Bonding Instrument (PBI), were less likely to complete an adequate six-week trial of medication. Patients who reported high maternal protection (maternal overprotection) on the PBI had poorer treatment response in the short-term at six weeks, and longer term, for two months of sustained recovery. However, abuse, whether sexual, physical, or psychological in nature, did not predict treatment response. Conclusions: The experience of having a neglectful father or an overprotective mother was more predictive of response to treatment for depression than abuse, suggesting that the quality of ongoing intra-familial relationships has a greater impact on treatment outcomes for depression than experiences of discrete abuse in childhood.

Original languageEnglish (US)
Pages (from-to)711-717
Number of pages7
JournalDepression and Anxiety
Issue number8
StatePublished - Aug 2009
Externally publishedYes


  • Abuse
  • Childhood adversity
  • Depression
  • Neglect
  • Parental Bonding Instrument (PBI)
  • Treatment predictors

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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