Journal of Affective Disorders
January 1, 2024
Liliana Patarroyo-Rodriguez, Vanessa M. Pazdernik, Jennifer L. Vande Voort et al.
12 citations
Sleep disturbances affect 94% of patients with treatment-resistant depression, with middle and early insomnia being the most common. Patients who experience hypersomnia (excessive sleep) before treatment show higher response rates and greater improvement in depressive symptoms after receiving intravenous ketamine or intranasal esketamine. Additionally, 15% of patients have an atypical depression phenotype, and most of them also achieve a positive response with greater symptom reduction. A trend toward faster response is seen in both the hypersomnia and atypical depression groups. These sleep-related features may help predict which patients will benefit from ketamine-based treatments.
Journal of Affective Disorders
August 15, 2023
Silvia J. Franco-Corso, Kate Y O'Malley, Saleena Subaiya et al.
12 citations
Non-ordinary states of consciousness (NOSCs) induced by mind-body practices such as meditation, yoga, and breathwork may improve symptoms of affective disorders and substance use disorders, according to a review of preliminary evidence. Qualitative and open-label studies suggest these practices produce NOSCs that correlate with short-term reductions in anxiety and depression, increased motivation to change addictive behaviors, and enhanced self-awareness and well-being. However, the literature is scarce, and more rigorous research is needed. Mind-body practices could offer a more accessible alternative to hallucinogen-based therapies for eliciting therapeutic NOSCs.
Journal of Affective Disorders
May 1, 2025
Ezgi Fındık, Neslihan Yılmaz Sezer, Menekşe Nazlı Aker et al.
11 citations
A Mindfulness-Based Childbirth and Parenting Program (MBCP) improved prenatal attachment and reduced depression, anxiety, and stress among pregnant women. In a randomized trial with 36 participants, those who completed the 8-week MBCP scored significantly higher on the Prenatal Attachment Inventory than the control group. Although between-group differences for depression, anxiety, and stress were not significant, within the MBCP group scores for these emotional states improved from baseline to follow-up. The program appears to be a useful tool for healthcare professionals supporting prenatal mental health.
Journal of Affective Disorders
April 1, 2025
Angela T H Kwan, Moiz Lakhani, Kayla M Teopiz et al.
11 citations
An analysis of the FDA Adverse Event Reporting System found that reports of hepatobiliary disorders differ between ketamine and esketamine. Compared to acetaminophen, ketamine was associated with disproportionately lower reporting of hepatitis, liver injury, drug-induced liver injury, hepatic failure, and acute hepatic failure, but disproportionately higher reporting of hepatic function abnormalities and hepatic cytolysis. For esketamine, there was no disproportionate reporting of most hepatobiliary toxicities relative to acetaminophen, except for disproportionately higher reporting of hepatic failure. The authors recommend periodic monitoring of liver function tests and clinical surveillance for signs of hepatobiliary disease in individuals receiving chronic ketamine or esketamine, though causality has not been established.
Journal of Affective Disorders
December 15, 2024
Liva G Lamontagne, Jennifer L Doty, David C Diehl et al.
11 citations
Mindfulness training apps may improve mental health among college students, with moderate certainty of evidence. A systematic review and meta-analysis of 47 studies found that these apps reduced stress by 0.435 standard deviation units and increased emotional well-being by 0.431 units, approaching medium effect sizes. Smaller effects were observed for depression (0.219 units) and anxiety (0.218 units). Distressed participants showed larger improvements in all outcomes except depression. The evidence was moderate for stress, depression, and well-being, and low-to-moderate for anxiety. Sustained usage remains a challenge, and more research is needed on optimal implementation and dosage.
Journal of Affective Disorders
June 1, 2024
Malvika Godara, Martin Hecht, Tania Singer
11 citations
Online mindfulness-based and partner-based socio-emotional interventions, both supported by weekly coaching, reduced depression and emotion regulation difficulties over 10 weeks compared to a waitlist control group. Trait anxiety decreased only after mindfulness training. Multidimensional resilience increased only after socio-emotional training, and stress recovery improved only after mindfulness training. Socio-emotional training reduced negative interpretation bias, and this reduction mediated decreases in depression and trait anxiety. Neither training reduced state anxiety or negative attention bias. The sample was subclinical and mostly female, limiting generalizability.
Journal of Affective Disorders
March 1, 2021
R. Mcintyre, Nelson B Rodrigues, Orly Lipsitz et al.
10 citations
The McIntyre and Rosenblat Rapid Response Scale (MARRRS) is a brief self-report measure of depression symptom severity that is sensitive to change with the rapid-acting antidepressant ketamine. In 64 adults with treatment-resistant depression receiving intravenous ketamine, the MARRRS showed high internal consistency and strong convergent validity with the established 16-Item Quick Inventory Depressive Symptoms Self-Report. The scale detected symptom changes across four infusions and loaded onto two factors: dysphoria and psychic anxiety. The findings suggest that outcome measures validated for rapid-acting treatments are needed to inform treatment progress and decisions.
Journal of Affective Disorders
October 1, 2025
Shuang Zhu, Peng Wang, Qingxia Liu et al.
8 citations
A randomized controlled trial with 183 adolescents diagnosed with major depressive disorder tested whether adding mindfulness-based cognitive therapy (MBCT) to standard treatment (TAU) improves cognitive function and reduces inflammatory markers. The MBCT group showed a noteworthy reduction in suicidal thoughts and greater improvement in depressive symptoms compared to the TAU-only group. Levels of the inflammatory marker IL-6 were significantly lower in the MBCT group after treatment. The results indicate that MBCT is effective and safe for reducing suicidal thoughts, alleviating depressive symptoms, and lowering serum IL-6 levels in depressed adolescents.
Journal of Affective Disorders
September 1, 2025
M. Olivola, Filippo Mazzoni, Barbara Tarantino et al.
8 citations
A six-month observational study of 36 patients with treatment-resistant depression found that those with poor mentalization abilities at the start had more severe depressive symptoms throughout treatment with esketamine. Greater cognitive rigidity appeared protective, possibly by stabilizing emotions and reducing negative thinking. The findings suggest esketamine may help break cognitive inflexibility and improve mentalization, supporting a personalized approach to treatment-resistant depression.
Journal of Affective Disorders
July 15, 2025
Tyler M Moore, Kathryn Walker, Emma Tung et al.
8 citations
Ketamine alone and ketamine combined with psychotherapy both rapidly reduce depression and PTSD symptoms, with no significant difference between the two approaches over 30 or 180 days. Analyzing overlapping samples of 202, 470, and 624 help-seeking individuals (about 60% female, average age 42) who received either ketamine alone or ketamine plus psychotherapy across 4 to 14 sessions, both groups showed substantial improvement with rapid initial decline followed by stabilization. Exploratory patterns suggested younger females may benefit more from combined treatment, while older males may do better with ketamine alone, but these differences were not statistically significant. Ketamine's effects appear robust enough that adding psychotherapy during acute treatment does not enhance outcomes, though longer-term benefits warrant further study.
Journal of Affective Disorders
July 9, 2025
Otto Simonsson, Peter S. Hendricks, Caroline M. Swords et al.
8 citations
In a large observational study of US adults aged 18–50, naturalistic psychedelic use was modestly linked to increased depressive symptoms over time. Among 12,345 participants followed longitudinally, 505 reported psychedelic use. Those who used psychedelics in a 'risk context'—such as a negative mindset or lack of psychological support—showed a moderate increase in depressive symptoms compared to non-users and to users without such risks. This association was explained by more challenging psychedelic experiences in that context. The findings indicate that psychedelic use outside controlled therapeutic settings may not be generally beneficial and could worsen depressive symptoms under certain conditions.
Journal of Affective Disorders
September 1, 2024
Angela T H Kwan, Joshua D. Rosenblat, Rodrigo B. Mansur et al.
8 citations
Ketamine and esketamine are effective for treatment-resistant depression and may help people with substance use disorder or alcohol use disorder when paired with behavioral therapy. However, concerns exist about their own abuse potential. Analyzing reports from the FDA Adverse Event Reporting System, ketamine showed significantly increased reporting odds for alcohol abuse, substance dependence, substance use disorder, substance abuse, drug dependence, drug use disorder, and drug abuse. In contrast, esketamine showed significantly reduced reporting odds for substance abuse, drug dependence, and drug abuse. Mixed results across different substance-related outcomes suggest possible beneficial effects, but causal links cannot be established due to data limitations.
Journal of Affective Disorders
July 15, 2024
Kelly T Hurst, Abigail Vogeley, Deanna K Greenstein et al.
8 citations
People who received ketamine for depression in early clinical trials at the National Institute of Mental Health (NIMH) were more likely to obtain ketamine or esketamine after leaving the research setting. Among 203 former participants followed up an average of nine years later, 25.6% had originally received ketamine at the NIMH. Those who had received ketamine were significantly more likely to have used ketamine or esketamine afterward. However, receiving ketamine at the NIMH was not linked to higher rates of suicide attempts, psychiatric hospitalizations, dissociation, hallucinations, or attempts to obtain non-prescribed ketamine. Participants who used ketamine or esketamine after discharge reported more depressive symptoms. No symptoms indicating abuse were reported. The findings highlight the need for long-term monitoring of patients receiving rapid-acting antidepressants.
Journal of Affective Disorders
April 15, 2024
Benjamin D. Brody, Nana Park, Alexander Christian et al.
8 citations
In a retrospective chart review of 41 psychiatrically hospitalized patients with non-psychotic major depressive disorder treated with ketamine infusions, 46.5% met criteria for response (a 50% reduction in depression scores) and 26.5% achieved remission (score of 10 or less on the Montgomery-Asberg Depression Rating Scale) during the treatment course. However, 10% of patients experienced adverse psychological or behavioral outcomes. The study lacked standardized training for clinicians administering the depression rating scales and had incomplete race/ethnicity data. Twice-weekly racemic ketamine infusion appears effective for inpatients, but the findings caution that unmonitored or at-home ketamine therapy may pose substantial risks.
Journal of Affective Disorders
December 1, 2017
Shona Neehoff, P. Glue
8 citations
Several possible explanations could account for the differing results observed in two assessments of the CADSS (Clinician-Administered Dissociative States Scale) performance.
Journal of Affective Disorders
May 1, 2025
Alessandro Cuomo, Simone Pardossi, Giovanni Barillà et al.
7 citations
In patients with treatment-resistant bipolar disorder, intravenous ketamine (average dose 0.8 mg/kg) significantly reduced depressive symptoms, including inner tension, sleep reduction, and suicidal ideation, over four weeks without triggering manic switches. Fifty-nine patients were treated consecutively, and improvements in Montgomery-Åsberg Depression Rating Scale scores were observed from the second week onward. Adverse events were generally mild to moderate. The findings suggest ketamine can be a well-tolerated option for bipolar depression when carefully monitored, though caution is warranted due to the inherent risk of mood switching in bipolar disorder.
Journal of Affective Disorders
January 15, 2025
Zhiliang Long, Jiao Li, Marco Marino
7 citations
Electroconvulsive therapy, ketamine infusion, and total sleep deprivation all reduced depressive symptoms in 127 patients with treatment-resistant depression, but they affected other clinical measurements and brain structures differently. All three treatments increased gray matter volume in the left caudate. Only electroconvulsive therapy increased gray matter volume in the hippocampus, parahippocampus, amygdala, insula, fusiform gyrus, and several occipital and temporal areas. Neither baseline gray matter volume nor its change correlated with depressive symptom improvement for any treatment. The findings suggest that different rapid interventions for treatment-resistant depression have distinct effects on brain structure, which may help personalize treatment.
Journal of Affective Disorders
January 15, 2025
Fernanda Palhano-Fontes, Patrícia Cavalcanti-Ribeiro, Kaike Thiê da Costa Gonçalves et al.
7 citations
Eight weekly subcutaneous injections of esketamine produced a 52.17% response rate and a 34.78% remission rate in 30 patients with treatment-resistant depression, with improvements in self-reported depressive symptoms sustained for up to six months. The open-label trial lacked a control group and had a small sample size, limiting causal interpretation and generalizability. Subcutaneous administration offers a cheaper, easier alternative to intravenous or intranasal routes with comparable plasma levels and fewer side effects.
Journal of Affective Disorders
August 1, 2023
Mu-Hong Chen, Ya-Mei Bai, Hui-Ju Wu et al.
7 citations
A single low-dose ketamine infusion (0.5 mg/kg) compared to a low-dose midazolam control (0.045 mg/kg) resulted in higher serum levels of the anti-aging hormone klotho three days after treatment in 48 patients with treatment-resistant depression and strong suicidal ideation. However, ketamine did not significantly increase klotho levels from baseline, and changes in klotho were not associated with changes in depressive or suicidal symptoms. Higher baseline klotho levels predicted a poorer antidepressant response to ketamine. The findings suggest klotho may be involved in ketamine's antidepressant mechanism, but further molecular studies are needed.
Journal of Affective Disorders
April 1, 2023
Olivier Payette, P. Lespérance, V. D. Jodoin et al.
7 citations
For people with treatment-resistant depression who did not benefit from transcranial magnetic stimulation (TMS), intravenous racemic ketamine may offer some help. In a small case series of 21 patients, a course of six ketamine infusions over two weeks was safe and produced few side effects. Average depression scores, measured by the MADRS scale, fell from 27.6 (moderate depression) to 18.6 (mild depression), a mean improvement of 34.5%. Four patients (19%) responded to treatment, and two of those (9.5%) achieved remission. The study was uncontrolled and retrospective, so results are preliminary.
Journal of Affective Disorders
March 15, 2025
Thomas D Meyer, Maya Ibrahim, Lauren N Vale et al.
6 citations
People with bipolar disorder have been excluded from most psychedelic research due to concerns about triggering mania or psychosis. This study used the Timeline Followback method to assess mood symptoms, substance use, and mental health in individuals with bipolar disorder one month before and three months after their most recent recreational psychedelic experience. Depressive symptoms and cannabis use significantly decreased, and the number of days without mental health symptoms increased. There were no significant changes in manic, psychotic, or anxiety symptoms. The findings suggest psychedelics may be safe and potentially beneficial for bipolar disorder, but randomized controlled trials are needed.
Journal of Affective Disorders
February 15, 2025
Zhan-Ming Shi, Xian-Jun Lan, Qing Chen et al.
6 citations
A meta-analysis of five randomized controlled trials involving 664 patients with major depressive disorder or bipolar depression found that intravenous (IV) ketamine produced a greater reduction in depressive symptoms 24 hours after the first treatment compared to electroconvulsive therapy (ECT). However, by the end of treatment, both approaches showed similar rates of response and remission. Neurocognitive outcomes were inconsistent across studies. IV ketamine caused more dissociation, blurred vision, dizziness, and double vision, while ECT led to more muscle pain. The faster onset of antidepressant effects with IV ketamine does not translate into superior long-term outcomes, and larger trials are needed to assess lasting efficacy and safety.
Journal of Affective Disorders
December 15, 2024
Giacomo d'Andrea, Andrea Miuli, Mauro Pettorruso et al.
6 citations
In patients with treatment-resistant depression, combining vortioxetine with esketamine nasal spray reduces depressive symptoms as effectively as the standard combination of an SSRI or SNRI with esketamine. The vortioxetine combination also showed a larger reduction in emotional blunting after three months and had fewer treatment-emergent side effects. These findings come from a post-hoc analysis of twenty patients, ten in each group. The authors suggest the vortioxetine-plus-esketamine regimen may be a valuable alternative, but they call for larger randomized controlled trials to confirm the results.
Journal of Affective Disorders
July 15, 2025
Hongjuan Wang, Hui Wang, Jojo Yan Yan Kwok et al.
5 citations
Mindfulness-based interventions (MBIs) improve several health outcomes for women going through menopause, including reducing menopausal symptoms, anxiety, depressive symptoms, stress, and sleep problems, while enhancing quality of life and mindfulness levels. These findings come from a meta-analysis of 18 randomized controlled trials involving 1,670 participants. The interventions showed good acceptability, with a low dropout rate (6%) and high adherence (79%). However, the overall quality of evidence was rated low to moderate due to methodological limitations and small sample sizes, so more rigorous research with longer follow-up is needed to confirm these benefits and understand how MBIs work.
Journal of Affective Disorders
June 15, 2025
Alexander Buschner, Christian Makiol, Jue Huang et al.
5 citations
Both mindfulness-based therapies and cognitive-behavioral therapy produce significant and clinically important reductions in depression symptoms, but mindfulness-based therapies do not show a meaningful advantage over CBT. A network meta-analysis of eight mindfulness-based and ten CBT studies, all comparing against treatment as usual, found that while an unweighted common-effects model suggested a slightly larger effect for mindfulness-based therapies, the difference was below the clinically relevant threshold. When using a random-effects model or weighted analysis, no significant difference between the two approaches emerged. The analysis was limited by high risk of bias, heterogeneity among studies, and low quality of evidence, highlighting the need for direct head-to-head comparisons.