Abstract

Patients with depression maltreated during childhood differ from those depressive patients without this background. In patients with early trauma the disease emerges earlier, it is more severe and does not respond to the classical antidepressant therapy. Despite this evidence, research regarding the clinical conceptualization and approach to these patients is still limited. The above becomes relevant in Chile, considering the high prevalence of depression and history of adverse childhood events among Chilean depressive consulting health services. Based on the conceptualization of complex Post traumatic stress disorder (PTSD), the overall objective of this article is to propose a conceptualization to the clinical characteristics presented in depressive patients with early abuse, who consult in a mental health service. We propose that in all these patients it needs to inquire actively about history of early adverse events, patterns of interpersonal difficulties, psychiatric comorbidity with emphasis on PTSD features and presence of dissociative symptoms. According to which of the areas is the most important to understand the reason of consultation and considering the observation of 41 patients treated in the context of the Psychic Tauma Unit in the Curicó Hospital, we postulate the existence of the following profiles: depressive, posttraumatic and dissociative. The main clinical characteristics of each profile are presented with a therapeutic approach.