Trauma na infância e transtorno de personalidade Borderline em sujeitos com transtorno depressivo maior

Abstract

Introduction: The consequences of traumatic developmental experiences, in addition to contributing to the incidence of major depressive disorder (MDD), can make such clinical pictures more complex and signify a greater propensity to personality disorders (DP). However, it is still unclear which subtype of specific trauma is involved in MDD comorbidity with Borderline Personality Disorder (BPD). Objective: To evaluate the association between subtypes of childhood trauma (physical and emotional neglect, sexual, physical and emotional abuse) with BPD in a population of individuals with MDD. Method: This is a cross-sectional study of individuals aged 18-60 who sought psychotherapeutic treatment at the Mental Health Research and Extension Outpatient Clinic (APESM) of the Catholic University of Pelotas (UCPel) and received a diagnosis of MDD between July 2012 to June 2015. The instruments used in the evaluation were: a questionnaire containing sociodemographic variables of the participants; the classification of the Brazilian Association of Research Companies (ABEP) to evaluate economic class; the Childhood Trauma Questionnaire (CTQ) to assess the history of early trauma; the Mini International Neuropsychiatric Interview Plus (MINI Plus) for the diagnosis of MDD; and Millon Clinical Multiaxial Inventory - III (MCMI-III) to evaluate the PD. Results: 429 individuals completed all assessment instruments. The prevalence of MDD comorbidity with BPD was 23.5% (n = 101) and we can verify that it is not working (p = 0.044), have suicide risk (p <0.001) and have some anxiety disorder (p = 0.051) were associated with a higher prevalence of BPD. The presence of any other personality disorder was associated with a higher prevalence of BPD (p <0.001). In relation to the subtypes of early trauma, with the exception of Physical Abuse (p = 0.061), 7 all others were associated with an increase in BPD: Physical Neglect (p = 0.004), Emotional Neglect (p <0.001), Sexual Abuse = 0.016) and Emotional Abuse (p <0.001). After adjusted analysis, the subtypes of early trauma did not remain associated with comorbidity between MDD and BPD. Some PD and the risk of suicide remained significantly associated with BPD in MDD comorbidity. Conclusion: We found no association between early trauma and comorbidity between MDD and BPD, but we found that comorbidity could be associated with a worse clinical course of MDD, characterized by higher rates of suicide risk and other personality disorders.