Journal of affective disorders
July 15, 2025
Hongjuan Wang, Hui Wang, Jojo Yan Yan Kwok et al.
5 citations
Mindfulness-based interventions (MBIs) improve several health outcomes for women going through menopause, including reducing menopausal symptoms, anxiety, depressive symptoms, stress, and sleep problems, while enhancing quality of life and mindfulness levels. These findings come from a meta-analysis of 18 randomized controlled trials involving 1,670 participants. The interventions showed good acceptability, with a low dropout rate (6%) and high adherence (79%). However, the overall quality of evidence was rated low to moderate due to methodological limitations and small sample sizes, so more rigorous research with longer follow-up is needed to confirm these benefits and understand how MBIs work.
Journal of affective disorders
June 15, 2025
Alexander Buschner, Christian Makiol, Jue Huang et al.
5 citations
Both mindfulness-based therapies and cognitive-behavioral therapy produce significant and clinically important reductions in depression symptoms, but mindfulness-based therapies do not show a meaningful advantage over CBT. A network meta-analysis of eight mindfulness-based and ten CBT studies, all comparing against treatment as usual, found that while an unweighted common-effects model suggested a slightly larger effect for mindfulness-based therapies, the difference was below the clinically relevant threshold. When using a random-effects model or weighted analysis, no significant difference between the two approaches emerged. The analysis was limited by high risk of bias, heterogeneity among studies, and low quality of evidence, highlighting the need for direct head-to-head comparisons.
Journal of affective disorders
June 10, 2025
Haibin Shi, Caihong Zheng, Bin Zhu
5 citations
A meta-analysis of 13 studies with 2,716 patients found that perioperative esketamine lowers the risk of postpartum depression and reduces Edinburgh Postnatal Depression Scale scores at 1 and 6 weeks after cesarean section, and decreases pain scores within 48 hours during movement and 24 hours at rest. However, esketamine increases adverse effects such as hallucinations, dizziness, blurred vision, and diplopia. Prenatal body mass index is inversely correlated with mood response to esketamine one week after surgery. The studies had clinical heterogeneity, used different EPDS thresholds for diagnosing postpartum depression, and lacked racial diversity.
Journal of affective disorders
January 15, 2025
Cinzia Cecchetto, Elisa Dal Bò, Emma T Eliasson et al.
5 citations
Exposure to human body odors (BOs) from happiness or fear, compared to clean air, reduced self-reported anxiety during mindfulness practice over two days in women with social anxiety symptoms. However, fear BO exposure also decreased heart rate variability, indicating a less physiologically relaxed state. No differences in skin conductance were found. The findings suggest that emotional BOs create a sense of social presence, potentially enhancing the ecological validity of psychological treatments, and may eventually be used to augment existing therapies.
Journal of affective disorders
November 1, 2024
J Douglas Bremner, David Williamson, Viola Vaccarino
5 citations
Dissociative symptoms can arise from psychological trauma or as a side effect of certain medications, making accurate assessment important. The 23-item Clinician Administered Dissociative States Scale (CADSS) was evaluated in 276 participants: 148 with trauma history and PTSD, 100 with trauma history but no PTSD, and 28 healthy controls without trauma or psychiatric disorder. The scale showed high internal consistency (Cronbach's alpha 0.91) and a single-factor structure. Trauma-exposed participants with PTSD had higher CADSS scores than those without PTSD or without trauma. Veterans with combat-related PTSD showed increased scores after exposure to combat-related stimuli. The CADSS performs reliably for assessing dissociation in psychologically traumatized individuals.
Journal of affective disorders
April 15, 2026
Gia Han Le, Sabrina Wong, Danica E Johnson et al.
4 citations
Ketamine and esketamine rapidly reduce depression in people with treatment-resistant depression and bipolar depression, but the synaptic mechanisms behind dosing and durability are unclear. This review of 61 clinical and 17 preclinical studies found that a single 0.5 mg/kg intravenous infusion produces antidepressant effects peaking at 24 hours and fading over 2-3 days. Early neurophysiological changes appear within 3-8 hours, consolidate by 24 hours, and are rarely detected beyond 3 days. Twice-weekly and thrice-weekly dosing produce comparable four-week outcomes, and weekly maintenance reduces relapse risk. Ketamine may open a plasticity window lasting about 2-3 days, and aligning dosing intervals with this window could optimize durability while minimizing drug exposure.
Journal of affective disorders
November 22, 2025
Carlos Trenado, Erich Seifritz, Sebastian Olbrich et al.
4 citations
Frontal EEG recordings before treatment with ketamine or esketamine in 43 people with major depressive disorder revealed that those who later responded to the medication had increased functional connectivity (measured by phase locking value and phase lag index) and decreased entropy (Renyi and Tsallis) compared to non-responders. Aperiodic spectral parameters were lower in responders but did not predict response. These EEG measures showed moderate predictive accuracy, with area under the ROC curve values of 0.7065 for Renyi entropy, 0.7101 for Tsallis entropy, and 0.7283 for phase lag index, suggesting frontal EEG patterns may serve as biomarkers for identifying individuals likely to benefit from (es)ketamine treatment.
Journal of affective disorders
September 15, 2025
Brandan K Penaluna, Jennifer L Vande Voort, William V Bobo et al.
4 citations
In people with treatment-resistant depression, intravenous ketamine improved symptoms across four depression subtypes: Sadness, Negative Thoughts, detachment/Interest and Activity, and Neurovegetative. After three infusions over 11 days, 53% of the 75 participants achieved remission. The Negative Thoughts subtype showed the least improvement, and the Neurovegetative subtype was the least responsive overall. Higher baseline Sadness scores were linked to lower remission rates, and a positive Sadness phenotype reduced the odds of remission (odds ratio 0.32). No meaningful sex differences in response were found by the end of treatment.
Journal of affective disorders
July 15, 2025
Mina Ansari, Taeho Greg Rhee, Mia C Santucci et al.
4 citations
Patients with obesity were significantly more likely to respond to intranasal esketamine for treatment-resistant depression than non-obese patients. Among 190 patients treated at a single clinic, 34.2% were obese. Obese patients had a 63% higher chance of achieving at least a 50% improvement on the Montgomery-Åsberg Depression Rating Scale compared to non-obese patients. However, when BMI was analyzed as a continuous measure, no linear relationship with treatment response was found. The authors suggest that increased body fat may prolong the presence of lipid-soluble esketamine or its metabolites, but the underlying mechanisms remain unknown.
Journal of affective disorders
May 1, 2025
Xiaohui Zhou, Li Zhang, Weiwei Gao et al.
4 citations
In a rat model of depression, modified electroconvulsive therapy (MECT) effectively reduced depressive symptoms but worsened cognitive impairments, increased hippocampal neuronal death, and triggered neuroinflammation. Adding esketamine, an FDA-approved antidepressant, reversed those cognitive deficits, reduced cell death and inflammation, and improved synaptic plasticity. Esketamine worked by increasing levels of the protein KLF4, which in turn blocked the p38 MAPK signaling pathway. When KLF4 was experimentally reduced, esketamine's protective effects disappeared, confirming its essential role. The findings suggest that combining esketamine with electroconvulsive therapy could protect against memory and thinking problems in patients.
Journal of affective disorders
March 1, 2025
Elizabeth D Ballard, Lucinda Neely, Laura Waldman et al.
4 citations
Suicidal ideation, depression, hopelessness, psychological pain, and traumatic stress are all elevated during a suicide crisis and respond to a single ketamine infusion. In a study of 118 adults spanning the suicide risk continuum, 14 high-risk individuals who had recently attempted or seriously considered suicide were compared with those whose crisis had resolved. A subset of 10 high-risk participants received open-label ketamine (0.5 mg/kg). Results were mixed depending on the assessment used, but all five clinical characteristics were elevated near the time of crisis and decreased after ketamine. The small sample and use of only one intervention limit the findings.
Journal of affective disorders
February 1, 2025
Farzaneh Ramezani, Peyman Mardani, Fatemeh Nemati et al.
4 citations
Ketamine alters brain activity in people with major depressive disorder, particularly in the anterior cingulate cortex, dorsolateral prefrontal cortex, and amygdala. Most reviewed studies found that these changes in brain activity correlate with improvements in depressive symptoms, involving the prefrontal cortex, ACC, and cortico-cerebellar circuits. The review notes a lack of longitudinal data on lasting effects and a small number of studies. It calls for more research on ketamine's mechanisms, long-term impact, dose-response optimization, and comparisons with other fast-acting antidepressants.
Journal of affective disorders
November 1, 2024
Anna C Oft, Samantha Philip, Emily Holz et al.
4 citations
Among 67 adults with anxiety disorders, both escitalopram and mindfulness-based stress reduction (MBSR) reduced partial days of missed work due to health problems after 24 weeks. Only MBSR was linked to improved job performance over the same period. Neither treatment outperformed the other on any work-related outcome at the study's end. The findings suggest that MBSR may improve work performance as effectively as SSRI medication for people with anxiety disorders, offering an alternative for those seeking better anxiety symptoms and workplace outcomes.
Journal of affective disorders
October 1, 2024
Chuntana Reangsing, Katemanee Moonpanane, Kanittha Pittchalard et al.
4 citations
An 8-week mindfulness-based intervention delivered through the Mind Space Application led to large reductions in stress and depression and a large increase in mindfulness among Thai university students with depression, compared with a waitlist control group. Anxiety also decreased, but the change was small to moderate and not statistically significant. Fifty participants were randomly assigned to either the app intervention or the waitlist. The findings suggest that such applications could serve as an alternative or complement to other treatments for improving psychological outcomes in university student populations.
Journal of affective disorders
January 28, 2026
Clara De Oliveira Lapa, Thiago Viola, Rodrigo Delfino et al.
3 citations
Intranasal esketamine substantially reduces depressive symptoms and increases remission rates over time in patients with treatment-resistant depression treated in routine clinical practice. A meta-analysis of nine observational studies found a large effect size (Hedges' g = -1.98) and that patients were about five times more likely to achieve remission at three months compared with the induction phase (odds ratio = 5.1). Treatment effectiveness was not influenced by gender or the presence of anxiety, personality, or substance use disorders. Any adverse event occurred in 82% of patients, most commonly dissociation (49%). The findings support esketamine's effectiveness and tolerability in real-world settings, though the observational design and lack of control groups warrant cautious interpretation.
Journal of affective disorders
October 1, 2025
Weng-Lam Chan, Sebastian Olbrich, Xinwen Jiang et al.
3 citations
Ketamine, a drug that blocks NMDA receptors and is thought to boost neuroplasticity, increased whole-brain EEG signal complexity during infusion in patients with major depressive disorder (MDD), most of whom had treatment-resistant depression. Higher complexity at the end of infusion predicted less symptom improvement the next day, while lower occipital complexity before treatment predicted a favorable response. A logistic model using occipital complexity had moderate predictive accuracy. No changes were seen in a different complexity measure, suggesting it is not useful as a biomarker. Occipital EEG complexity may help predict which patients will benefit from ketamine therapy.
Journal of affective disorders
September 1, 2025
Elizabeth A Hoge, Mihriye Mete, Amanda W Baker et al.
3 citations
For adults with anxiety disorders, Mindfulness-Based Stress Reduction (MBSR) delivered via videoconference was comparably effective to in-person MBSR, but MBSR-VC did not meet the threshold for non-inferiority compared to the antidepressant escitalopram (ESC) delivered by videoconference. In a randomized controlled trial with 202 participants, MBSR-VC and ESC-VC showed similar average improvement on the Clinical Global Impression of Severity scale (1.39 vs 1.51 points), but non-inferiority was not supported. In-person treatments had a greater impact on social anxiety than their video versions. ESC-VC received higher satisfaction ratings and had a greater effect on panic symptoms than MBSR-VC. Remotely delivered MBSR is a viable option for anxiety disorders, though social anxiety may benefit more from in-person care.
Journal of affective disorders
August 15, 2025
Stefanie Cavalcanti, Vanessa K Pazdernik, Jennifer L Vande Voort et al.
3 citations
Among adults with treatment-resistant depression receiving ketamine or esketamine, those reporting high perceived stress before treatment had lower odds of remission and needed more treatment sessions to achieve remission. In a cohort of 39 patients, 66.7% had high perceived stress. Each 5-point increase on the Perceived Stress Scale reduced the odds of remission by 60%, independent of baseline depression severity. Patients with high stress required a median of 3 treatments to reach remission versus 1 for those with low-to-moderate stress. The observational design and lack of a placebo group limit the findings.
Journal of affective disorders
August 15, 2025
Yohei Ohtani, Hideaki Tani, Shiori Honda et al.
3 citations
About 30% of people with treatment-resistant depression respond to ketamine, but reliable predictors of response have been lacking. This study examined whether the ratio of glutamate+glutamine (Glx) to GABA in the dorsal anterior cingulate cortex (dACC) could predict ketamine's effectiveness. In a double-blind randomized trial with an open-label extension involving 30 participants, a higher baseline Glx/GABA ratio in the dACC correlated with greater improvement in depression scores (measured by the HDRS-17). After ketamine treatment, a reduction in this ratio also correlated with symptom improvement. The findings suggest that an excitatory-inhibitory imbalance in the dACC may help predict which patients will benefit from ketamine therapy.
Journal of affective disorders
August 15, 2025
Xinya Hong, Sen Xu, Gaozhong Sun et al.
3 citations
Eight sessions of intranasal esketamine, given weekly, helped patients with lung cancer and major depression quit smoking. Self-reported continuous abstinence at six months was 44.1% in the esketamine group, and biologically verified abstinence was 28.8%. Depression and anxiety severity also improved, along with cognitive function, nicotine dependence, urge to smoke, and respiratory symptoms. No serious adverse events occurred. The trial indicates esketamine is a safe and effective aid for smoking cessation in this population.
Journal of affective disorders
July 17, 2025
Alene Sze Jing Yong, Sue E Brennan, Suzie Bratuskins et al.
3 citations
Australia's Therapeutic Goods Administration rescheduled MDMA in July 2023, permitting authorized prescribing for PTSD outside clinical trials. This manuscript describes development of an Australian Clinical Practice Guideline on MDMA-assisted psychotherapy for PTSD using the GRADE process. The guideline will compare benefits and harms of MDMA-assisted psychotherapy against other treatments, drawing on high-quality systematic reviews. A multidisciplinary Guideline Development Group will consider evidence certainty, patient values, resources, equity, acceptability, and feasibility. The guideline will be published on MAGICapp and disseminated through peer-reviewed publications and conferences. A Companion Guide will be created for people with PTSD and their carers.
Journal of affective disorders
July 15, 2025
Burcu Kök Kendirlioğlu, Melike Özmen, Sudesu Uluçay et al.
3 citations
For treatment-resistant depression, combining electroconvulsive therapy (ECT) with intravenous ketamine on consecutive days does not improve remission rates over ECT alone. In a retrospective review of 30 patients, both the concurrent-treatment group and the ECT-alone group showed similar treatment response rates of about 67% on the Hamilton Depression Rating Scale. The concurrent group had a significantly higher mean age (56.5 vs. 43.1 years) and more prior depressive episodes. During 6- to 12-month follow-up, 60% of the combined-treatment group and 66.6% of the ECT-alone group avoided hospitalization. The authors suggest that when either treatment alone fails, the concurrent protocol may still be worth trying, but the small sample and retrospective design limit confidence.
Journal of affective disorders
June 9, 2025
Sara Ellis, Catherine Bostian, Anna Donnelly et al.
3 citations
Among veterans with severe treatment-resistant depression, a single 25 mg dose of psilocybin produced significant reductions in depression scores that were sustained for up to 12 months, though antidepressant effects began to wane after 6 months and more substantially after 9 months. At 12 months, 40% of 10 participants maintained a response (≥50% reduction in MADRS) and 30% maintained remission (MADRS ≤10). The study was a small, open-label pilot without a control group, so the findings suggest but do not demonstrate lasting benefit.
Journal of affective disorders
January 15, 2025
Qiongyao Yang, Yitan Yao, Xiaoping Yuan et al.
3 citations
In patients with depression, six intravenous infusions of esketamine (0.4 mg/kg) over 11 days significantly reduced depressive symptoms, with mean Montgomery-Asberg Depression Rating Scale scores dropping from 32.11 to 15.10. Memory function—including immediate memory, language, attention, and delayed memory—improved, and plasma nerve growth factor (NGF) levels rose from 226.13 to 384.37 pg/mL. A positive correlation existed between baseline memory function and NGF levels, while higher baseline memory was linked to smaller NGF increases. These findings suggest NGF may contribute to esketamine's memory-enhancing effects, though the open-label design limits certainty.
Journal of affective disorders
December 15, 2024
Sabrina Wong, Gia Han Le, Rodrigo Mansur et al.
3 citations
A review of preclinical and clinical studies examined whether ketamine affects metabolic parameters, particularly glucose-insulin homeostasis, in people with major depressive disorder (MDD) and treatment-resistant depression (TRD). In experimental diabetic conditions, ketamine did not disrupt glucose-insulin homeostasis. In adults with MDD, ketamine was associated with GLUT3 transporter upregulation and altered metabolomic signatures. In adults with TRD, ketamine increased brain glucose uptake in the prefrontal cortex. The available evidence suggests ketamine does not adversely affect metabolic parameters, though few clinical studies have evaluated its effects on glucose-insulin homeostasis in MDD. Ketamine appears safe regarding metabolic disturbances commonly seen with other augmentation therapies.