In adults with treatment-resistant depression, intranasal esketamine plus an antidepressant improved depressive symptoms within 24 hours, as measured by the MADRS scale (average 3.44 points greater reduction than placebo). However, esketamine raised the risk of elevated blood pressure threefold and dissociation nearly sixfold. The analysis of nine randomized controlled trials supports esketamine as a fast-acting option, but short follow-up periods, varying dosing protocols, and the notable side-effect profile limit broader conclusions. Long-term safety and durability of response remain insufficiently studied.
Group counselling based on mindfulness significantly reduces perceived stress in pregnant women with gestational diabetes. In a randomized trial, 80 pregnant women with gestational diabetes were assigned to either eight sessions of mindfulness counselling focused on emotion regulation or a control group receiving no intervention. Before the intervention, both groups completed a demographic questionnaire and the Cohen Perceived Stress Questionnaire. One month after the intervention, the mindfulness group's mean perceived stress score dropped from 29.72 to 26.10, a statistically significant decrease. No differences in socio-demographic characteristics existed between groups. Mindfulness-based counselling helps pregnant women with gestational diabetes manage stress and may reduce adverse physical and psychological outcomes.