Distinct Roles of Therapeutic Expectations and Dissociative Symptoms in Antidepressant Response During Ketamine Treatment in Routine Care
Willys Cantenys, Zeynep Yoldas, Luc Masset, Alix Romier, Léonie Samion, Marion Imbault, Thai-moc Tram Tran, Flavia Megda Garcia, Samar Soltani, Martina Marradi, Hanh-dan Ho, Antoinette Gohier, Chahinaz Doulazmi, Marianne Chesneau, Cécile Jadaan, Joy Bulut, Ndilyam Djonouma, Salma Charradi, Anne Claret Tournier, Philippe Fossati, Liane Schmidt
medRxiv Preprint Server April 23, 2026 preprint DOI: 10.64898/2026.04.23.26351276 via medRxiv
Summary
Ketamine is known for its rapid antidepressant effects, but the roles of therapeutic expectations and dissociative symptoms in this process are not well understood. The study aims to clarify how these factors contribute to changes in depressive symptoms and their associations with treatment outcomes.
Abstract
Background Ketamine is a rapid-acting antidepressant that produces acute dissociative symptoms. In routine care, the respective contributions of therapeutic expectations and dissociative symptoms to antidepressant response, and the directionality of their associations with depressive symptom change, remain poorly characterized.