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The Telegraph reports that a new study has found childhood trauma to physically scar the brain and increases the likelihood of severe depression for later in life.

Scientists have now linked changes in the physical structure of the brain to early traumatic experiences and to worse mental health later in life. The study found a “significant” link between people who were mistreated as children with a smaller insular cortex. This part of the brain is thought to assist in regulating emotions. The study focused specifically on “limbic scarring.” Previously, research has linked the scarring to stress.

The study involved 110 patients, aged 18 to 60, with major depression. The patients were given a questionnaire about childhood trauma, which covered physical abuse and neglect, emotional abuse and neglect, and sexual abuse. Afterwards, the patients were given MRI scans to search for changes in the structure of the brain.

Dr. Nils Opel, from the University of Munster, Germany, led the study. He said, “Given the impact of the insular cortex on brain functions such as emotional awareness, it’s possible that the changes we saw make patients less responsive to conventional treatments.”

Opel continued, “Future psychiatric research should therefore explore how our findings could be translated into special attention, care and treatment that could improve patient outcomes.”

The study suggests that limbic scarring, which causes a reduction in the area of the insular cortex, could make a depression relapse more likely. The research finds that childhood mistreatment is among the strongest risk factors for depression.