Journal of Affective Disorders
May 1, 2023
M. Cladder-Micus, J. Vrijsen, A. Fest et al.
For chronically depressed patients who have not responded to prior treatments, mindfulness-based cognitive therapy (MBCT) produces clinical benefits that persist for at least six months after the program ends. Depressive symptoms, quality of life, rumination, mindfulness skills, and self-compassion all remained stable during follow-up, and remission rates actually increased further. Patients who entered treatment with higher levels of rumination showed greater reductions in depressive symptoms and better quality of life at six months, after accounting for initial symptom severity. Other factors—duration of the current depressive episode, degree of treatment resistance, childhood trauma, and baseline mindfulness or self-compassion—did not predict outcomes.
Journal of Affective Disorders
February 1, 2023
Li-Gang Zhang, Ling-Fei Cheng, Ting-Ting Wang et al.
Nightmares, insomnia, depression, and anxiety are all linked to cognitive deficits in adolescents. An online survey of 6,014 adolescents found that females, senior high school students, and those with poor academic performance reported more nightmares, insomnia, and cognitive deficits; city dwellers had higher depression and anxiety scores. Cognitive deficits were positively correlated with nightmares, insomnia, depression, and anxiety. Insomnia, depression, and anxiety together acted as a chain mediating the relationship between nightmares and cognitive deficits: nightmares appear to affect cognition indirectly by first worsening insomnia, which then worsens depression and anxiety. Because the study was cross-sectional, causal relationships could not be determined, and reporting or volunteer bias may exist. Early identification and treatment of frequent nightmares may help reduce negative outcomes.
Journal of Affective Disorders
December 1, 2022
Anastasia Levinta, Shakila Meshkat, Roger S McIntyre et al.
Ketamine rapidly reduces depressive symptoms in people with treatment-resistant depression, but its effectiveness may diminish as the number of prior failed treatments increases. A systematic review of 18 randomized controlled trials found that ketamine and esketamine worked at both lower and higher stages of treatment resistance, yet effect sizes and duration of benefits were greater in studies involving patients with fewer prior antidepressant failures. Variability in how studies defined treatment resistance and measured outcomes prevented clear comparisons of efficacy across different resistance stages. The authors conclude that while ketamine remains broadly effective, more failed treatment trials may reduce its efficacy, and participant-level data are needed to clarify the relationship between resistance level and response.
Journal of Affective Disorders
October 15, 2022
Isak Joneborg, Yena Lee, Joshua D. Di Vincenzo et al.
A systematic review of five randomized-controlled trials found that ketamine-assisted psychotherapy (KAP) had a significant positive effect on primary outcome measures for adults with substance use disorders and treatment-resistant depression, but the data is mixed. The single trial examining KAP for treatment-resistant depression found no benefit. The review notes a lack of large, replicated clinical trials and no studies actively examining mechanisms of action. Evidence suggests temporary neural changes caused by ketamine, such as NMDAR inhibition and increased synaptic neuroplasticity, may affect treatment outcomes. Preliminary findings also suggest adjunct psychotherapy, changes in perspective, and spirituality may play a role.
Journal of Affective Disorders
September 1, 2022
Bing Zhang, Wenxian Fu, Yan Guo et al.
A systematic review and meta-analysis of seven randomized controlled trials (479 participants) found that mindfulness-based cognitive therapy (MBCT) reduced suicidal ideation and depressive symptoms more than treatment as usual in patients with current depression. The effect on suicidal ideation was modest (standard mean difference -0.33) and on depression was larger (-0.96). The authors conclude MBCT is an effective intervention for reducing both outcomes in depressed patients.
Journal of Affective Disorders
February 1, 2022
Jianyu Que, Le Shi, Wei Yan et al.
Among 16,220 hospital workers in Wuhan, China, surveyed during the COVID-19 pandemic, 13.3% reported suicidal ideation in the past month. Exposure to COVID-19-related traumatic events was significantly associated with insomnia severity, nightmare frequency, and suicidal ideation. After controlling for potential confounders, nightmares—but not insomnia, depression, or anxiety—were independent risk factors for suicidal ideation. Pathway analyses indicated that the relationship between traumatic event exposure and suicidal ideation was fully mediated by nightmares, with a proportion mediated of 66.4%. The authors suggest that nightmare intervention might be considered a component of suicide prevention strategies.
Journal of Affective Disorders
February 2, 2021
Pablo Roca, C. Vázquez, Gustavo Díez et al.
Both a mindfulness program (MBSR) and a compassion program (CCT) improved mindfulness, decentering, body awareness, and self-compassion in 431 participants. MBSR produced larger gains in present-moment awareness (decentering and body awareness), while CCT produced larger gains in socio-emotional changes (common humanity and empathic concern). Both programs similarly reduced psychological distress (stress, anxiety, depression), maladaptive cognitive processes (rumination, thought suppression), and improved well-being. Mediation analyses indicated that MBSR reduces distress and improves well-being through changes in present-moment awareness mechanisms, whereas CCT achieves the same outcomes through socio-emotional mechanisms.
Journal of Affective Disorders
January 15, 2021
Dakota Mauzay, Emily M LaFrance, Carrie Cuttler
Inhaling cannabis is associated with short-term reductions in OCD symptoms. In an analysis of 1,810 cannabis use sessions tracked by 87 self-identified OCD patients via the Strainprint® app, compulsions dropped by 60%, intrusions by 49%, and anxiety by 52% from before to after inhalation. Higher CBD concentrations and higher doses predicted larger reductions in compulsions. Over 31 months, later sessions showed smaller reductions in intrusions, suggesting possible tolerance. Baseline symptom severity and dose remained stable. The absence of a placebo control and the self-selected sample limit causal conclusions.
Journal of Affective Disorders
December 27, 2020
Sonal Mathur, M. Sharma, S. Balachander et al.
Mindfulness-based cognitive therapy (MBCT) is more effective than stress management training for treating obsessive-compulsive disorder (OCD). In a randomized trial of 60 outpatients with OCD, 80% of those receiving MBCT responded to treatment compared with 27% of those receiving stress management training. MBCT led to greater reductions in illness severity, obsessive beliefs about responsibility/threat and perfectionism/intolerance of uncertainty, and anxiety. The findings suggest MBCT is a viable treatment for OCD, though the small sample and high attrition in the control group limit generalizability.
Journal of Affective Disorders
October 7, 2020
Éva Gál, Simona Stefan, I. Cristea
A meta-analysis of 34 randomized controlled trials (7566 participants) found that mindfulness meditation apps significantly reduce perceived stress, anxiety, and depression and improve psychological well-being at post-test compared to control conditions. No significant effects were found for distress or general well-being. The authors caution that results should be interpreted carefully due to the small number of included studies, uncertain risk of bias, and heterogeneity.
Journal of Affective Disorders
July 21, 2020
A. Docteur, C. Mirabel-Sarron, Héline Kaya Lefèvre et al.
Mindfulness-based cognitive therapy (MBCT) reduces depressive symptoms, dysfunctional attitudes, and overgeneral autobiographical memories while increasing specific memories in people with bipolar I disorder. Patients who received MBCT showed significantly fewer depressive symptoms and less overgeneral memory compared to those on a waiting list. Baseline general autobiographical memory and omissions predicted lower anxiety and dysfunctional attitudes improvement after therapy, but memory improvement did not explain MBCT's effect on depression or dysfunctional attitudes. The findings suggest that MBCT reduces cognitive reactivity and memory impairment in bipolar disorder, and that autobiographical memory training before MBCT may influence its efficacy, but memory improvement and clinical symptom improvement are unrelated.
Journal of Affective Disorders
July 21, 2020
J. Kingston, L. Becker, J. Woeginger et al.
A brief 10-minute mindfulness meditation practiced daily for two weeks, followed by a single values session, reduced depression symptoms more than the values session alone among young adults with elevated depression. The combined approach was especially beneficial for those with higher baseline depression severity, while those with lower depression showed no difference between conditions. Deterioration rates were unexpectedly high in the values-only group. The online, self-help intervention had no therapist contact. Findings are preliminary due to high dropout (50%) and no follow-up.
Journal of Affective Disorders
June 1, 2020
A. Camargo, A. P. Dalmagro, A. Zeni et al.
Combining low doses of ketamine and guanosine produces an antidepressant-like effect in mice, likely by activating synaptogenic signaling pathways in the hippocampus and prefrontal cortex. The treatment increased phosphorylation of mTOR and p70S6K in the hippocampus and raised levels of synaptic proteins PSD-95 and GluA1 in the prefrontal cortex. A single co-administration also reversed depressive-like behavior induced by chronic corticosterone exposure. The authors suggest that guanosine could augment ketamine's effects, potentially offering a therapeutic strategy for treatment-resistant depression.
Journal of Affective Disorders
December 1, 2019
Mu-Hong Chen, Wei-Chen Lin, Pei-Chi Tu et al.
A subanesthetic dose of ketamine alters functional connectivity in prefrontal cortex circuits of patients with treatment-resistant depression. Forty-eight patients were randomly assigned to receive a standard dose (0.5 mg/kg), a low dose (0.2 mg/kg), or a placebo infusion. The standard dose reduced connectivity between the left dorsal anterior cingulate cortex and right dorsolateral prefrontal cortex with other frontal regions; the low dose produced more widespread reductions in connectivity. Changes in suicidal ideation correlated with connectivity changes in opposite directions depending on dose. The findings suggest that modulation of prefrontal circuits underlies ketamine's antidepressant and antisuicidal effects.
Journal of Affective Disorders
October 30, 2019
G. Lönnberg, W. Jonas, E. Unternaehrer et al.
A mindfulness-based childbirth and parenting program (MBCP) reduced perceived stress and depressive symptoms more than a standard Lamaze childbirth class among first-time pregnant women at risk of perinatal depression. Compared to the control group, MBCP also increased positive states of mind and self-reported mindfulness. Changes in mindfulness, especially non-reactivity and non-judging of inner experience, appeared to mediate the improvements in stress, depression, and positive mood.
Journal of Affective Disorders
March 1, 2019
M. Carpena, P. Tavares, C. Menezes
A six-week focused meditation training reduced depression and anxiety symptoms among university students compared to a waiting list control group. Those who continued meditating showed lower depression scores at 6 months and lower anxiety scores at both 6 and 12 months follow-up. The maintenance of symptom reductions depended on continued practice, suggesting permanent meditation programs could support mental health in this population.
Journal of Affective Disorders
July 6, 2018
D. Lovas, Zev Schuman-Olivier
Mindfulness-based cognitive therapy (MBCT) shows promise as an adjunctive treatment for bipolar disorder, with preliminary evidence suggesting it may improve anxiety, residual depression, mood regulation, and attentional and frontal-executive control without precipitating mania. A systematic review of 13 studies found wide variation in methodological quality, with most studies underpowered or lacking power calculations. Due to study heterogeneity and quality issues, meta-analysis was not possible, so net effects cannot be estimated. More high-quality research is needed to confirm clinical efficacy.
Journal of Affective Disorders
August 15, 2017
James W. Murrough, Elizabeth Wade, Sehrish Sayed et al.
A combination of dextromethorphan and quinidine, given at up to 45/10 mg twice daily for 10 weeks, reduced depression scores in patients with treatment-resistant depression. Twenty patients with unipolar treatment-resistant depression enrolled; six discontinued early. Depression scores on the Montgomery-Asberg Depression Rating Scale dropped by an average of 13 points, and on the Quick Inventory of Depressive Symptomatology by nearly 6 points. Response and remission rates were 45% and 35%, respectively. No treatment-emergent suicidal thoughts, psychosis, or dissociation occurred. The open-label, proof-of-concept design limits conclusions, but results suggest the combination is tolerable and warrants larger placebo-controlled trials.
Journal of Affective Disorders
April 1, 2008
J.M.G. Williams, Y. Alatiq, C. Crane et al.
Mindfulness-based Cognitive Therapy (MBCT) reduced anxiety and depressive symptoms in people with bipolar disorder who were in remission but had suicidal ideation or behavior. In a small pilot randomized trial, bipolar participants receiving MBCT showed greater immediate improvement in anxiety compared to those on a waitlist, and both bipolar and unipolar participants had fewer residual depressive symptoms. The findings are preliminary due to the small sample and cannot be generalized to individuals without suicidal symptoms.