Childhood maltreatment

Childhood maltreatment increases the risk of suicide regardless of the comorbid psychiatric disorder encountered. This increase in the risk of suicide might also be the indirect consequence of the greater severity of comorbid psychiatric disorders or the result of the impact of child abuse on intermediary dimensions such as emotion regulation and impulsivity. It is therefore important to research a history of maltreatment in childhood when treating a patient because it not only provides information on the suicide risk but also on the therapeutic direction to take. A worse response to treatment in abused subjects is indeed expected compared to non-abused ones, and the care, whether pharmacological or psychotherapeutic, may be more complicated. In the neurobiological point of view, several recent studies have shown that epigenetics plays a crucial role in mediating the impact of childhood adversities on adulthood psychopathology. These studies have highlighted quantitative (more epigenetic changes) as well as qualitative epigenetic changes in subjects reporting childhood maltreatments. Further researches are needed to better define whether these epigenetic changes may be useful, in a clinical point of view, as possible biomarkers for suicide and/or for treatment response.