Mood Emot 2019 Nov; 17(3): 89-98  
Childhood Trauma and Treatment Implications in Major Depressive Disorder in South Korea: Comparison with Medical Outpatients and Two-Year Follow-Up
Chonggi Kim, MD1, Yuri Jeong, MD1, Eun-kyung Kim, PhD1, Seon-Cheol Park, MD, PhD2, Hwa Yeon Jo, MD1, Daeho Kim, MD, PhD1
1Department of Psychiatry, Hanyang University College of Medicine, Seoul, 2Department of Psychiatry, Inje University Haeunndae Paik Hospital, Busan, Korea
Correspondence to: Daeho Kim, MD, PhD
Department of Psychiatry, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
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Received: August 26, 2019; Revised: September 30, 2019; Accepted: October 2, 2019; Published online: November 30, 2019.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Little is known about the specific types of childhood trauma and their relationship to treatment-related issues in major depressive disorder (MDD). This study examined trauma experiences and treatment-related variables in outpatients with MDD at a psychiatric department of a university hospital in Korea.
Methods: First, 75 outpatients with MDD were compared to medical outpatients without MDD matched by age, sex, income, and educational qualifications. Both groups completed the Life Stressor Checklist-Revised, which assesses comprehensive life events. Second, treatment-related variables and medication compliance measured by the Compliance Rating Scale were investigated for the two-year period after the initial assessment.
Results: The MDD group had experienced a significantly higher number of lifetime traumas than the control group (p=0.003), including more frequent witnessing of family violence (p<0.001), adulthood physical assault by a family member (p<0.001), and childhood emotional abuse (CEA) (p<0.001). CEA was associated with early onset of the first depressive episode and premature termination of pharmacotherapy; childhood physical neglect was associated with premature termination and less time in therapy.
Conclusion: Our findings support the important influence of childhood emotional trauma and its relationship to treatment retention.
Keywords: Major depressive disorder; Child abuse; Child neglect; Treatment adherence and compliance; Patient dropouts

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