Psychiatry research
September 1, 2026
Valerio Ricci, Andrea Paggi, Giovanni Martinotti et al.
In patients with cannabis-induced first-episode psychosis, dissociative symptoms—especially depersonalization and derealization—are strong independent predictors of poor functional recovery over 24 months. Among 72 patients, three recovery trajectories emerged: Rapid Recovery (34.7%, GAF +29.1 points), Gradual Recovery (40.3%, GAF +15.7 points), and Persistent Impairment (25.0%, GAF +4.7 points). A symptom-function discrepancy occurred in 31.9% of patients, where psychotic symptoms improved but functioning did not; these patients had higher baseline dissociation scores (33.8 vs. 18.1). Dissociation mediated 35% of cannabis's negative effect on functional outcomes. A high-risk subgroup (22%) with elevated dissociation, depression, and continued cannabis use showed minimal improvement despite treatment. Routine dissociation assessment and targeted interventions may improve outcomes.
Psychiatry research
August 1, 2026
Pietro Carmellini, Andrea Fagiolini, Mario Pinzi et al.
In a real-world clinic, intravenous ketamine reduced depressive symptoms in patients with treatment-resistant unipolar and bipolar depression. Both groups improved significantly, but those with bipolar depression showed faster and greater improvement starting at two weeks and lasting through three months. Dissociative side effects were mild and did not increase over time; women with unipolar depression reported higher dissociative symptoms at three months. No sex differences in antidepressant efficacy were found. The findings suggest ketamine is effective for treatment-resistant depression, with stronger benefits for bipolar depression.
Psychiatry research
July 1, 2026
Yao Xiao, Ping Xie, Danlei Li et al.
A network meta-analysis of 18 randomized controlled trials (1722 participants) compared pharmacological treatments for postpartum depression. Compared with placebo, saffron, fluoxetine, esketamine, brexanolone, and zuranolone showed signals of improvement in depressive symptom severity. Fluoxetine, saffron, and zuranolone were associated with higher response rates, though estimates for fluoxetine and saffron were imprecise. Brexanolone was the only intervention showing a statistically significant improvement in remission, but it may have a potentially unfavourable acceptability signal based on all-cause discontinuation. Zuranolone was associated with an increased incidence of adverse events. The evidence is limited by sparse networks, imprecision, and clinical heterogeneity, so findings should be interpreted cautiously.
Psychiatry research
June 16, 2026
Filippo Mazzoni, Fabiola Raffone, Arianna De Ciechi et al.
Among 90 outpatients with treatment-resistant depression, half also had borderline personality disorder (BPD). Depressive symptoms, measured by the MADRS scale, improved substantially over six months of intranasal esketamine treatment. The BPD group showed faster early improvement, and from one month onward had higher response rates (≥50% reduction in symptoms). Remission rates at six months were similar between groups (48.9% with BPD vs. 57.8% without). Anxiety and impulsivity decreased across the whole sample, and cognitive function did not worsen. No serious adverse events or dropouts occurred. Comorbid BPD did not hinder the overall remission outcome.
Psychiatry research
April 1, 2026
Wen-Huei Siao, Tzong-Shi Wang, Liang-Chun Wang et al.
Ketamine, a drug that blocks NMDA receptors and produces schizophrenia-like effects, causes different behavioral responses depending on the mouse strain and dose. Adolescent mice from four strains—C57BL/6J, DBA, BALB/c, and 129S1—received ketamine injections of 0, 25, or 50 mg/kg, and their movement in an open field was tracked. Before and after treatment, locomotor activity varied significantly among strains, with C57BL/6J mice most active and 129S1 mice least active. Ketamine dose-dependently increased movement in C57BL/6J mice, caused brief excitation in DBA mice at 25 mg/kg, delayed excitation in BALB/c mice at 50 mg/kg, and minimal changes in 129S1 mice. These findings demonstrate that genetic background and dose modulate ketamine sensitivity during adolescence.
Psychiatry research
June 1, 2025
Flávia Vieira, Ana Teresa Caliman-Fontes, Breno Souza-Marques et al.
A systematic review of 46 studies on ketamine and its enantiomers for major depressive disorder identified 16 assessment tools used to measure suicidal behavior. Most were explicit, clinician-rated scales such as the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HAM-D), and Beck Scales for Suicide Ideation. Only the Suicide Ideation and Behavior Assessment Tool (SIBAT) was specifically developed for rapid-acting antidepressant trials. The variety of instruments used across studies makes comparisons difficult. The MADRS is suggested as a reasonable choice for assessing suicidal behavior in this context, though no single tool is universally preferable.
Psychiatry research
January 1, 2025
Li Kevin J, Slama Natalie E, Chen Ingrid et al.
Patients with treatment-resistant depression who received intravenous ketamine infusions (0.5 mg/kg over 40 minutes twice weekly for three weeks) were 72% more likely to achieve a 50% or greater reduction in depression symptoms compared to similar patients receiving standard medication management. The study followed 570 adults in a large healthcare system, matching groups on sex, race, age, and baseline depression severity. Although the ketamine group showed a higher remission rate (8% versus 5%), this difference was not statistically significant. Co-occurring anxiety and personality disorders, as well as more severe baseline depression, predicted worse outcomes regardless of treatment.