Biological links between psychological factors and adolescent depression: childhood trauma, rumination, and resilience

Background:The psychosocial factors play an important role in the development of depression in adolescents. However, whether adolescent depression induced by psychosocial factors leads to biological alterations remains unclear. Here, we used metabolomics techniques to explore the links among childhood trauma, rumination, resilience, and adolescent depression.Methods: We selected 57 adolescent depression patients and recruited 53 healthy adolescents as the normal group in the same period. We used the Childhood Trauma Questionnaire (CTQ), Hamilton Depression Scale (HAMD), Resilience Inventory (CD-RISC), and Redundant Thoughts Response Scale (RRS) to assess the adolescent group psychologically. According to the CTQ, CD-RISC, and RRS scores using 27% high and low grouping basis, 30 cases were categorized into 30 cases in the high childhood trauma group , 30 cases in the low childhood trauma group , 30 cases in the low redundancy group, 30 cases in the high redundancy group , 30 cases in the low resilience group, and 30 cases in the high resilience group. Blood specimens were collected from all adolescents and metabolic data were obtained using LC-MS. The data were statistically analyzed using SPSS.25 software, SIMCA software (version 16.0.2).Results: We found that resilience, childhood trauma, and rumination were significantly associated with the development of adolescent depression. There were significant differences in metabolites between adolescent depression and healthy individuals, between individuals with high childhood trauma and low childhood trauma, between individuals with high redundancy of thoughts and low redundancy of thoughts, and between individuals with high resilience and low resilience. The two important common metabolic differentiators between childhood trauma and depression are dehydroepiandrosterone sulfate (DHEAS), LPA(22:6) . The two important common metabolic differentiators between rumination and depression are N-Acetyl-L-aspartic acid, DHEAS. The two important common metabolic differentiators between resilience and depression are LPA(22:6), Pseudouridine.Conclusion: DHEAS and LPA(22:6) may be protective factors for the development of depression in adolescents. Rumination thinking may mediate the onset of adolescent depression by suppressing DHEAS levels. Childhood trauma and resilience may both mediate the onset of adolescent depression by modulating LPA(22:6) levels.背景：社会心理因素在青少年抑郁的发生发展中发挥重要作用。然而，由社会心理因素诱发的青少年抑郁是否会引发生物学改变，目前仍不明确。本研究采用代谢组学技术，探究儿童期创伤、反刍思维、心理弹性与青少年抑郁之间的关联。 方法：本研究纳入57例青少年抑郁患者，同期招募53名健康青少年作为正常对照组。采用儿童期创伤问卷（Childhood Trauma Questionnaire, CTQ）、汉密尔顿抑郁量表（Hamilton Depression Scale, HAMD）、心理弹性量表（Resilience Inventory, CD-RISC）以及反刍思维反应量表（Redundant Thoughts Response Scale, RRS）对青少年群体进行心理学评估。以各量表评分的27%分位数作为高低分组依据，将受试者分别划分为高儿童期创伤组、低儿童期创伤组各30例，高反刍思维组、低反刍思维组各30例，高心理弹性组、低心理弹性组各30例。采集所有青少年的血液标本，采用液相色谱-质谱联用法（Liquid Chromatography-Mass Spectrometry, LC-MS）获取代谢组学数据。使用SPSS 25软件、SIMCA软件（版本16.0.2）进行统计学分析。 结果：本研究发现，心理弹性、儿童期创伤与反刍思维均与青少年抑郁的发生发展存在显著关联。青少年抑郁患者与健康个体、高儿童期创伤者与低儿童期创伤者、高反刍思维者与低反刍思维者、高心理弹性者与低心理弹性者之间的代谢产物水平均存在显著差异。儿童期创伤与抑郁共有的重要代谢差异标志物为硫酸脱氢表雄酮（dehydroepiandrosterone sulfate, DHEAS）与LPA(22:6)；反刍思维与抑郁共有的重要代谢差异标志物为N-乙酰-L-天冬氨酸与DHEAS；心理弹性与抑郁共有的重要代谢差异标志物为LPA(22:6)与假尿苷（Pseudouridine）。 结论：DHEAS与LPA(22:6)可能是青少年抑郁发生发展的保护因素。反刍思维可能通过抑制DHEAS水平介导青少年抑郁的发病。儿童期创伤与心理弹性均可能通过调控LPA(22:6)水平介导青少年抑郁的发病。