New research using magnetic resonance imaging (MRI) shows that abuse or emotional neglect during childhood combined with genetic factors can result in structural brain changes, rendering some individuals more vulnerable to  depression. The study results appear in Neuropsychopharmacology.

24 patients (aged 18-65 years) being treated as inpatients for major depression were investigated with high-resolution structural MRI and childhood stress assessments. Special analysis programs were used to measure brain regions. These patients were compared with 27 healthy control subjects from the local community who were matched for age and gender. Further research is needed in a larger number of patients and controls to identify the underlying causes of depression and stress-gene interaction on brains structure as well as function.

"This improved neurobiological understanding shows how stress and genetic variants interact and affect brain structure and function. In turn it demonstrates how it could affect a person's propensity for depression. These structural alterations of the brain are associated with a higher vulnerability to depression and a more chronic course of the depression might be associated with further structural changes," said Trinity Trinity College Dublin Professor Thomas Frodl.

"Therefore, early intervention in the case of major depression is necessary to increase the chance of a good disease outcome. Fortunately, depression can be treated very well by psychotherapy and antidepressant medication. Moreover, prevention strategies for childhood neglect and misuse are highly important to increase public health and to avoid in later life for these individuals, the burden of major depression."

The world health organization (WHO) says that major depression is one of the most important human diseases with a prevalence of about 10% worldwide. Approximately 500,000 people in Ireland have or will develop major depression in their life. The WHO has forecast that major depression will be the second most common cause of disability by 2020. Advances in this area will have a high impact on overall disease costs.

Citation: Frodl et al., 'Childhood Stress, Serotonin Transporter Gene and Brain Structures in Major Depression', Neuropsychopharmacology, February 2010; doi: 10.1038/npp.2010.8