Prevalence of emotional blunting and its association with childhood adverse experiences in depressive episodes

Abstract

Emotional blunting (EB) is common in patients with depressive episodes. This study aimed to study its prevalence in remitted and mild-to-moderate depressive episodes, and explore its association with adverse childhood experiences (ACEs). This cross-sectional study included patients aged 18–65 years with mild depressive episodes in major depressive disorder (MDD), persistent depressive disorder (PDD), and bipolar disorder (BPD). EB and adverse childhood experiences were assessed using the Oxford Depression Questionnaire (ODQ) and the ACE questionnaire, respectively. The severity of depressive symptoms was measured using the Hamilton Depression Rating Scale (HAM-D). Statistical analyses used Pearson’s correlation coefficients. A total of 106 participants completed the study. Prevalence of EB based on a single-question screening and ODQ cut-off score of ≥ 26 were 55.6%, and 89%, respectively. There were no significant differences in prevalence among diagnostic groups ( p  > 0.05). The prevalence was significantly lower in remitters (HAM-D ≤ 7) than non-remitters (45.3% vs. 66%, X 2 = 4.97, p  < 0.05). Correlation analyses in entire sample showed significant correlations between the ODQ total score and HAM-D score, PHQ-9 score, and the number of depressive episodes (all p  < 0.05). The Not Caring (NC) domain of the ODQ was positively correlated with ACE subscale scores for emotional abuse ( r  = 0.259, p  = 0.007) and physical abuse ( r  = 0.208, p  = 0.033), and negatively correlated with emotional support ( r  = − 0.25, p  = 0.01). Subgroup analyses among remitters ( n  = 53) showed that NC scores were correlated with emotional abuse ( r  = 0.304, p  = 0.027) and emotional support ( r  = − 0.328, p  = 0.017). The emotional detachment (ED) domain of the ODQ was correlated with the ACE domestic violence subscale ( r  = 0.286, p  = 0.038). EB was present in more than half of patients with depressive episodes. Remission was associated with a lower prevalence of EB; however, the prevalence remained high even among remitters. The severity of EB was correlated with the severity and recurrence of depressive symptoms. The Not Caring domain was associated with reported emotional abuse and domestic violence during childhood, even among remitted patients.