Resilience and childhood trauma in mood disorders: Psychopathological implications and treatment response

Childhood trauma is a key risk factor for mood disorders and is associated with greater clinical severity, while resilience may act as a protective factor. This study investigates how childhood trauma and resilience interact to shape psychopathology and treatment response in patients with major depressive disorder (MDD) and bipolar disorder (BD).

The study included 669 participants: 569 patients (380 MDD, 189 BD) and 100 healthy controls (HC). Symptom severity was assessed using standardized scales, with follow-up evaluations of depressive symptoms at six months. All participants completed the Childhood Trauma Questionnaire (CTQ) and Connor-Davidson Resilience Scale (CD-RISC).

Patients showed lower resilience and higher childhood trauma scores than HC (both p < 0.001), with more marked differences in those with depressive or anxiety symptoms (p < 0.05). In MDD, low resilience was linked to anhedonia, psychomotor retardation, general psychopathology, suicidality, and non-remission (all p ≤ 0.001), while in BD, it was associated with depressive and anxiety severity and anhedonia (all p ≤ 0.01). Childhood trauma was unrelated to most outcomes, except for higher scores in suicidal MDD patients (p = 0.010), and showed an inverse correlation with resilience in MDD and HC. Linear regression showed that gender (p = 0.013) and anhedonia (p = 0.005) significantly predicted resilience. Logistic regression revealed that higher resilience predicted remission (p = 0.012).

Resilience and childhood trauma influence clinical severity in mood disorders. Resilience emerged as a protective factor and predictor of remission, supporting its role as a therapeutic target.