In major affective disorders, early life trauma predict increased nitro-oxidative stress, lipid peroxidation and protein oxidation and recurrence of major affective disorders, suicidal behaviors and a lowered quality of life

  • Juliana Brum Moraes
  • Michael Maes
  • Chutima Roomruangwong
  • Kamila Landucci Bonifacio
  • Decio Sabbatini Barbosa
  • Heber Odebrecht Vargas
  • George Anderson
  • Marta Kubera
  • Andre F. Carvalho
  • Sandra Odebrecht Vargas Nunes
Original Article


Early life trauma (ELT) may increase the risk towards bipolar disorder (BD) and major depression (MDD), disorders associated with activated neuro-oxidative and neuro-nitrosative stress (O&NS) pathways. It has remained elusive whether ELTs are associated with O&NS and which ELTs are associated with distinct affective disorder phenotypes. This case-control study examined patients with BD (n = 68) and MDD (n = 37) and healthy controls (n = 66). The Child Trauma Questionnaire (CTQ) was used to assess specific ELT. We measured malondialdehyde (MDA), lipid hydroperoxides (LOOH), superoxide dismutase (SOD), catalase, advanced oxidation protein products (AOPP); NO metabolites (NOx), paraoxonase 1 activity, zinc, albumin, high density lipoprotein cholesterol and -SH groups and computed z-unit weighted composite scores. Physical neglect significantly predicts higher z-unit weighted composite scores of LOOH+SOD, LOOH+SOD+NOx, LOOH+SOD+NOx + MDA and LOOH+SOD+NOx + AOPP. Sexual abuse was associated with a significantly lower composite score of zinc+albumin+SH. Emotional abuse was associated with severity of depression and anxiety, number of depressive and manic episodes, alcohol and hypnotics use, lifetime suicidal behavior and lowered quality of life. Sexual abuse was associated with an increased risk towards BD, but not MDD. ELT, especially physical neglect, may drive increased (nitro-)oxidative stress coupled with lipid and protein oxidation, which - together with emotional abuse - may play a role in severity of illness, lowered quality of life and MDD. ELTs are also associated with the onset of BD, but this link did not appear to be related to activated O&NS pathways. These novel findings deserve confirmation in prospective studies.


Depressive disorder Bipolar disorder Child abuse Oxidative stress Antioxidants Suicide 



The authors wish to thank the Centre of Approach and Treatment for Smokers, Psychiatric Unit at UEL, Clinical Laboratory of the University Hospital and Laboratory of Research and Graduate College Hospital (LPG), Brazil.

Author contribution

All authors contributed to the writing up of the paper. The work was designed by SOVN, MM, HOV and JBM. Data were collected by SOVN, JBM and HOV. Laboratory analyses were conducted by KLB and DSB. Statistics were performed by MM. MM, GA, CR, MK and AFC revised the manuscript and provided relevant intellectual content. All authors revised and approved the final draft.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Juliana Brum Moraes
    • 1
  • Michael Maes
    • 1
    • 2
    • 3
    • 4
    • 5
    • 6
  • Chutima Roomruangwong
    • 2
  • Kamila Landucci Bonifacio
    • 1
  • Decio Sabbatini Barbosa
    • 1
  • Heber Odebrecht Vargas
    • 1
  • George Anderson
    • 7
  • Marta Kubera
    • 8
  • Andre F. Carvalho
    • 9
  • Sandra Odebrecht Vargas Nunes
    • 1
  1. 1.Health Sciences Graduate Program, Health Sciences CenterState University of LondrinaLondrinaBrazil
  2. 2.Department of PsychiatryChulalongkorn UniversityBangkokThailand
  3. 3.Department of PsychiatryMedical University of PlovdivPlovdivBulgaria
  4. 4.RevitalisWaalreThe Netherlands
  5. 5.IMPACT Strategic Research CentreDeakin UniversityGeelongAustralia
  6. 6.IMPACT Strategic Research Centre, School of MedicineDeakin UniversityGeelongAustralia
  7. 7.CRC Scotland & LondonLondonUK
  8. 8.Department of Experimental Neuroendocrinology, Institute of PharmacologyPolish Academy of SciencesKrakowPoland
  9. 9.Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of MedicineFortalezaBrazil

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