Childhood maltreatment is a strong risk factor for the onset of major depressive disorder (MDD) and associated with unfavorable course of the disease. Both, maltreatment and MDD have been independently associated with structural alterations in partly overlapping brain regions suggesting that brain structural changes could mediate the adverse influence of maltreatment on clinical outcome in MDD. In this study the relationship between childhood trauma, brain structural alterations and adverse disease course was investigated in a longitudinal design. Our results suggest that cortical surface area reductions might mediate the prospective association between early life stress and future depression relapse.
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