Outpatients with major depressive disorder (MDD) and a history of physical violence in childhood had lower levels of serum total cholesterol than outpatients with MDD and no history of physical violence in childhood, according to a study published in Psychiatry Research.

Adverse childhood experiences (ACEs) can have an impact on individual health, both mental and physical. Researchers in the current study analyzed data from the larger NeuroDep Study, which were collected during 2011 to 2012 from outpatients being treated at the Department of Psychiatry at Kuopio University Hospital, Kuopio, Finland.

Exclusion criteria included bipolar disorder, history of epilepsy, psychosis, and mental symptoms linked to substance abuse. Researchers only focused on at-home childhood physical violence, due to small sample sizes in other categories of ACEs, thereby excluding survivors of sexual violence or participants who only observed violence against others.

Ultimately, 78 outpatients were included for analysis (mean age 38.6; range 20-61): 24 who experienced childhood physical violence and 54 who did not. Although only 58 patients had available follow-up data (mean follow-up time 8 months; range 5-13 months), there were not significant differences between those who remained in the study and those who did not.

Multivariate models indicated that the outpatients with MDD who experienced physical violence in childhood had lower levels of total cholesterol than participants with MDD who had not experienced physical violence in childhood (Cohen’s d for difference=0.6), and these associations persisted after adjusting for gender, age, socioeconomics, lifestyle, psychiatric status, metabolic condition, low-grade inflammation, depression chronicity, somatic diseases, medications, and suicidality.

No differences between the 2 groups were observed in low-density lipoprotein cholesterol levels (Cohen’s d for difference=0.27) or high-density lipoprotein cholesterol (Cohen’s d for difference=0.04), and childhood physical violence was not associated with low-grade inflammation.

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Study investigators conclude that “[a]lterations in cholesterol levels could be due to lifestyle factors and alterations in cholesterol biosynthesis, and the role of these processes should be investigated in the future. Analyzing these processes could add to understanding of the biochemical mechanisms underlying the alterations in lipid levels in those with ACEs and might lead to possible new interventions to prevent adverse health effects related to ACEs.”


Kraav SL, Tolmunen T, Kärkkäinen O, et al. Decreased serum total cholesterol is associated with a history of childhood physical violence in depressed outpatients [published online December 21, 2018]. Psychiatry Res. doi: 10.1016/j.psychres.2018.12.108