Lifetime history of childhood adversity and substance abuse in patients with treatment resistant depression

Both adverse childhood experiences (ACEs) and substance abuse have shown individual associations with treatment-resistant depression (TRD). Yet, limited research has explored the joint association of ACEs and substance abuse in TRD patients. This study aimed to evaluate how the amount and type of ACE exposure increase the risk of lifetime substance abuse in a clinical sample of 725 outpatients diagnosed with major depressive disorder (MDD) or persistent depressive disorder.Logistic regression analyses were used to assess whether heightened ACE exposure increased the risk of substance abuse, and to examine the relationship between five ACE subtypes (e.g., sexual abuse (CSA), physical violence, injury/illness, childhood grief, and parental upheaval) and history of substance abuse.Greater ACE exposure increased risk of substance abuse. CSA independently predicted a history of substance abuse. This provides further evidence for the additive effects of ACEs and that CSA may have a unique link to substance abuse.