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Depression Research and Treatment
Volume 2014, Article ID 608671, 10 pages
http://dx.doi.org/10.1155/2014/608671
Review Article

Depression and Psychological Trauma: An Overview Integrating Current Research and Specific Evidence of Studies in the Treatment of Depression in Public Mental Health Services in Chile

1Department of Psychiatry, Medical School, Universidad de Talca, Chile
2Mental Unit Hospital de Curicó, Curicó, Chile
3Communal Mental Health Program, Communal Health Department of Curicó, Chile
4Mental Health Formative Practices, Medical School, Universidad de Talca, Chile
5Department of Psychiatry, Medical School, Universidad de los Andes, Santiago de Chile, Chile
6Department of Psychiatry, Universidad de Talca, Chile
7Mental Health Unit, Hospital de Talca, Chile
8Mental Health Unit, CESFAM Curicó-Centro, Curicó, Chile

Received 30 July 2013; Revised 2 November 2013; Accepted 18 November 2013; Published 17 February 2014

Academic Editor: Frans G. Zitman

Copyright © 2014 Verónica Vitriol et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In the last two decades, different research has demonstrated the high prevalence of childhood trauma, including sexual abuse, among depressive women. These findings are associated with a complex, severe, and chronic psychopathology. This can be explained considering the neurobiological changes secondary to early trauma that can provoke a neuroendocrine failure to compensate in response to challenge. It suggests the existence of a distinguishable clinical-neurobiological subtype of depression as a function of childhood trauma that requires specific treatments. Among women with depression and early trauma receiving treatment in a public mental health service in Chile, it was demonstrated that a brief outpatient intervention (that screened for and focused on childhood trauma and helped patients to understand current psychosocial difficulties as a repetition of past trauma) was effective in reducing psychiatric symptoms and improving interpersonal relationships. However, in this population, this intervention did not prevent posttraumatic stress disorder secondary to the extreme earthquake that occurred in February 2010. Therefore in adults with depression and early trauma, it is necessary to evaluate prolonged multimodal treatments that integrate pharmacotherapy, social support, and interpersonal psychotherapies with trauma focused interventions (specific interventions for specific traumas).