Which factor is associated with a higher recurrence risk of major depressive disorder after treatment?

Childhood maltreatment is recognized as a significant risk factor for a higher recurrence of major depressive disorder (MDD) after treatment. Research has consistently shown that individuals who have experienced maltreatment during childhood, such as physical, emotional, or sexual abuse, face a greater vulnerability to developing chronic or recurrent forms of depression. The trauma associated with these early adverse experiences can lead to lasting changes in brain structure and function, increasing the likelihood of depressive episodes reemerging later in life.

These early experiences can also affect an individual’s coping mechanisms, affect regulation, and interpersonal relationships, all of which are crucial in managing stressors that can trigger depressive episodes. Therefore, when evaluating risk factors for recurrent depression, the history of childhood maltreatment stands out as a critical element influencing long-term mental health outcomes.

In contrast, the presence of factors like no prior exposure to adversity or older age at the initial onset does not inherently increase the risk of recurrence in the same way. Similarly, while substance misuse can complicate and worsen depressive symptoms, it is often considered a separate issue that may not correlate directly with the underlying risk factors for recurrence caused by early developmental trauma.