Journal of affective disorders
April 15, 2024
Jinjun Liu, Wei Duan, Zeping Xiao et al.
15 citations
Online group Mindfulness-based Cognitive Therapy (MBCT) reduced clinician-rated depression and anxiety symptoms in Chinese outpatients with depression, regardless of whether they were taking medication. After a 10-week program, scores on the Hamilton Depression Scale and Hamilton Anxiety Scale dropped significantly, with more than half of patients showing at least a 50% reduction in depression scores. However, self-reported depression, mindfulness, and self-acceptance did not change significantly. Attendance was high, with 85% of participants completing more than four sessions. The findings suggest that shifting MBCT from an in-person to an online format can be effective for treating depression in this population.
Journal of affective disorders
December 15, 2024
Ethan Faries, Landon A Mabe, Ronald L Franzen et al.
13 citations
Repetitive transcranial magnetic stimulation (rTMS) produced significantly larger reductions in depression scores than electroconvulsive therapy (ECT) in adolescents with treatment-resistant depression, and potentially larger reductions than ketamine. A meta-analysis of 10 observational studies examined standardized mean differences in depression scores for youth aged 10-24 treated with ECT, rTMS, or ketamine. ECT had a significantly lower standardized mean difference of 1.99. No significant difference was found between ECT and ketamine. The comparison of ketamine versus rTMS suggested a potential difference favoring rTMS. rTMS shows promise as a first-line treatment for pediatric treatment-resistant depression due to its favorable side effect profile compared to ECT.
Journal of affective disorders
October 15, 2024
Angela T H Kwan, Joshua D Rosenblat, Rodrigo B Mansur et al.
13 citations
Ketamine and esketamine are increasingly prescribed for treatment-resistant mood disorders and suicide risk, but ketamine is also misused. Analyzing reports in the World Health Organization pharmacovigilance database up to January 2024, ketamine showed elevated reporting odds ratios for alcohol abuse (3.24), substance dependence (12.48), substance use disorder (170.44), substance abuse (2.94), drug dependence (2.88), drug use disorder (11.54), and drug abuse (2.85). Esketamine had reduced odds for substance abuse (0.41), drug dependence (0.083), and drug abuse (0.052), and no increased odds for any alcohol or substance misuse parameter. These associations do not establish causation.
Journal of affective disorders
May 1, 2023
Guy M Goodwin, Megan Croal, Lindsey Marwood et al.
13 citations
Blinding in psychiatric clinical trials is considered ideal, but unblinding due to subjective drug effects raises concerns about demand characteristics undermining research findings. For conventional antidepressants, the strong link between dose and subjective effects does not correspond to a strong relationship with efficacy in randomized controlled trials, disproving the idea that unblinding primarily drives trial outcomes. Instead, early changes in brain function predict treatment outcomes and align with neuroscience. For psychedelic treatment of depression, unblinding is inevitable, but the therapeutic effect stems directly from serotonin receptor activation and altered brain connectivity, not just expectancy. A dose-response relationship is expected with novel mechanisms. Unblinding does not invalidate genuine recovery.
Journal of affective disorders
August 1, 2025
Morgan C H Cheng, Christine E Dri, Hana Ballum et al.
12 citations
Ketamine and esketamine produce rapid antidepressant effects in major depressive disorder and treatment-resistant depression, but their impact on patient-reported quality of life has been unclear. A systematic review of five studies found that both agents improve quality of life measures on scales such as the WHOQOL-BREF, Assessment of Quality of Life 8D, and EuroQol-5 Dimension-5 Layers, with statistically significant results. However, the studies had an overall moderate risk of bias and varied in the quality-of-life scales used and study duration. Further research should examine effects on specific quality-of-life domains.
Journal of affective disorders
March 1, 2025
Xiang Liu, Zhipeng Wei, Lifeng Li et al.
12 citations
People with major depressive disorder show widespread damage to the brain's white matter, particularly in fibers connecting different regions. A two-week treatment with intravenous esketamine (0.25 mg/kg) effectively reduced depression, anxiety, and suicidal thoughts and improved cognitive function in 20 patients compared to 20 healthy controls. However, brain scans revealed that the damaged white matter did not recover during this short treatment period. The degree of damage in certain projection fibers was linked to the severity of anxiety and suicidal ideation. The study lacked a placebo control and many patients also took sertraline, making it difficult to isolate esketamine's specific effects on the brain.
Journal of affective disorders
February 1, 2025
Grant Jones, Matthew X Lowe, Sandeep Nayak et al.
12 citations
Psilocybin, the psychoactive compound in magic mushrooms, is linked to improved mental wellbeing on average, but few studies examine how effects differ by race. In a large online longitudinal study of 2,833 people planning naturalistic psilocybin use, race/ethnicity moderated changes in spiritual wellbeing, cognitive flexibility, and emotion regulation (expressive suppression) at 2–3 months post-experience, but not at 2–4 weeks. Participants of Color reported minor differences in context and subjective effects, such as being more likely to set an intention before use. Both groups showed comparable reductions in anxiety and depression, with no significant moderation by race.
Journal of affective disorders
January 1, 2025
Qing-Bin Zeng, De-Cheng Zou, Xing-Bing Huang et al.
12 citations
For people with treatment-resistant depression, electroconvulsive therapy (ECT) is a common option. Esketamine, a fast-acting antidepressant, had not been tested as an anesthetic for ECT. In a double-blind randomized trial, 40 patients received either esketamine or propofol anesthesia for eight ECT sessions. Esketamine-ECT was non-inferior to propofol-ECT for reducing depressive symptoms after eight sessions. Response rates were 80% for esketamine versus 70% for propofol, and remission rates were 65% versus 55%, but non-inferiority was not confirmed for these outcomes. Cognitive function was similar between groups. Results for anxiety, suicidal ideation, and adverse events were inconclusive. Larger replication studies are needed.
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
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
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
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
Fernanda Palhano-Fontes, Patricia 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
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
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.