Journal of Affective Disorders Reports最新文献

{"title":"Effects of acute stress on executive functions in depression, generalised anxiety and borderline personality disorder","authors":"T.M. Scott ,&nbsp;Joanne M. Dickson","doi":"10.1016/j.jadr.2025.100917","DOIUrl":"10.1016/j.jadr.2025.100917","url":null,"abstract":"<div><h3>Background</h3><div>Acute stress adaptively alters executive functions (EFs) essential for emotion regulation. Emerging systems of psychiatric classification, such as the Hierarchical Taxonomy of Psychopathology (HiTOP) and the Research Domain Criteria, emphasise the underlying mechanisms and dimensional nature of psychopathology. Distress disorders—a subfactor within the HiTOP model including major depressive disorder, generalised anxiety disorder and borderline personality disorder—are characterised by altered stress reactivity, impaired emotion regulation, and modest responsiveness to first-line psychotherapies. This systematic review sought to examine whether distress disorders and their related symptoms confer heightened vulnerability to transient EF impairment under conditions of acute stress.</div></div><div><h3>Methods</h3><div>A comprehensive search of articles published in ProQuest, PsycINFO, PubMed, Scopus and Web of Science prior to December 31st, 2022 identified 17 suitable studies examining stress-induced alterations to working memory, inhibition and cognitive flexibility in the context of distress disorders and associated symptoms.</div></div><div><h3>Results</h3><div>This review found a heightened susceptibility to stress-induced impairment of working memory in depression, and of response inhibition in borderline personality disorder—even for sub-clinical presentations of depressive symptoms wherein diagnostic criteria for a depressive disorder were not met. Findings for cognitive flexibility were inconclusive.</div></div><div><h3>Limitations</h3><div>While a thorough systematic review was conducted, heterogeneity in study design and methodologies precluded inclusion of a meta-analysis<em>.</em></div></div><div><h3>Conclusions</h3><div>The findings indicate that altered stress reactivity leads to maladaptation of EF under acute stress, and subsequent disruption of adaptive emotion regulation strategies. The present finding may help account for non-responsiveness among therapeutic interventions predicated upon cognitively-demanding emotion regulation strategies.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100917"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality in the treatment of depression; what therapeutic strategies does VR target?","authors":"Nancy Kramer Freher ,&nbsp;Martine van Bennekom ,&nbsp;Anika Bexkens ,&nbsp;Wim Veling ,&nbsp;Claudi L.H. Bockting","doi":"10.1016/j.jadr.2025.100912","DOIUrl":"10.1016/j.jadr.2025.100912","url":null,"abstract":"<div><h3>Background</h3><div>Major Depressive Disorder (MDD) is one of the most prevalent mental health conditions and has a tremendous impact on those affected. Immersive Virtual Reality (VR) technology has high potential to improve psychotherapy for MDD, as VR can personalize the treatment process and directly influence affect. Research on VR interventions for MDD is emerging, but current applications for treatment are heterogeneous and lack strong theoretical support. This scoping review aims to identify the therapeutic strategies that should and can be targeted in VR interventions for depression.</div></div><div><h3>Methods</h3><div>A systematic search of the literature was conducted in PubMed, PsycINFO, Ovid Medline, Embase, Web of Science, Google Scholar, Clinical Trials Register, and the ‘Dutch Trial Register’ from inception through November 2023 to identify the most relevant research.</div></div><div><h3>Results</h3><div>Findings from 43 studies included in this review resulted in the following potential therapeutic strategies: 1) psychoeducation (n=5), 2) behavioral activation (n=16), 3) cognitive restructuring (n=4), 4) enhancing positive affect (n=5), 5) mental imagery (n=4), 6) skills training (n=3), 7) enhancing cognitive functioning (n=3), and 8) other (n=3).</div></div><div><h3>Limitations</h3><div>We did not conduct a systematic assessment of the methodological quality of the studies nor perform a statistical analysis of the results.</div></div><div><h3>Conclusions</h3><div>VR shows potential to facilitate the treatment process for patients with depression in different ways, providing excellent prospects for personalizing and potentially improving the treatment of MDD. Future studies should focus on evaluating presumed mechanisms of change to fully understand the added value of VR in the treatment of depression.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100912"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and Reliability of the Dutch version of the Affective Control Scale","authors":"Hendrik-Jan De Vuyst ,&nbsp;James W. Griffith ,&nbsp;Eline Belmans ,&nbsp;Filip Raes","doi":"10.1016/j.jadr.2025.100910","DOIUrl":"10.1016/j.jadr.2025.100910","url":null,"abstract":"<div><h3>Background</h3><div>The Affective Control Scale (ACS) is a widely-used instrument for evaluating the fear of losing control over emotions, a key factor implicated in anxiety and depressive disorders. However, despite its widespread use, substantial inconsistencies have raised questions about the scale's reliability and validity.</div></div><div><h3>Methods</h3><div>This study aimed to assess the factor structure of the Affective Control Scale (ACS) using confirmatory factor analysis (CFA) in two Dutch-speaking samples (n₁ = 250, n₂ = 325). Various factor structures, as previously proposed in the literature, were examined. Convergent validity was assessed by correlating the resulting factors with concurrent measures of anxiety and depression.</div></div><div><h3>Results</h3><div>In both samples, a bifactor model excluding reverse-scored items demonstrated the best overall fit. However, despite showing high reliabilities, the specific factors exhibited low attributable score variance. Furthermore, the convergent validity assessment revealed poor associations between these specific factors and measures of anxiety and depression.</div></div><div><h3>Limitations</h3><div>The study's generalizability is limited due to the predominantly female samples. Additionally, the complexities of bifactor models may lead to overfitting of the data.</div></div><div><h3>Conclusions</h3><div>We conclude that a bifactor model excluding all reverse-scored items offers the most robust fit. Nevertheless, while the ACS is effective in measuring general fear of emotions, its ability to assess specific emotional fears is limited. Clinically, these findings underscore the importance of focusing on the overall fear of emotions rather than its specific components. Therefore, we recommend the use of a simplified, 30-item version of the ACS that assesses general fear of emotions.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100910"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction notice to: “Default mode intranetwork resting-state functional connectivity is correlated with increased symptom severity in common anxiety disorders: A systematic review and meta-analysis” [Journal of Affective Disorders Report 14 (2023), 100674]","authors":"Zachary P. Pierce ,&nbsp;Jessica M. Black","doi":"10.1016/j.jadr.2024.100853","DOIUrl":"10.1016/j.jadr.2024.100853","url":null,"abstract":"","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100853"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing brain morphological correlates of premenstrual symptoms in young healthy females","authors":"Sara B. Marjanovic ,&nbsp;Madelene Christin Holm Bukhari ,&nbsp;Rikka Kjelkenes ,&nbsp;Irene Voldsbekk ,&nbsp;Claudia Barth ,&nbsp;Lars T. Westlye","doi":"10.1016/j.jadr.2025.100916","DOIUrl":"10.1016/j.jadr.2025.100916","url":null,"abstract":"<div><div>While 90 % of females with a menstrual cycle will experience premenstrual symptoms in their reproductive years, it is estimated that 20 % experience treatment-warranted emotional, behavioral, or somatic symptoms in the premenstrual phase of their menstrual cycle. Premenstrual symptoms have been partly attributed to the brain's sensitivity to menstrual cycle-related hormonal fluctuations, which may be modulated by individual differences in the structural characteristics of the brain. In a population-based sample of 292 non-pregnant females aged 23–43 years, we tested for associations between self-reported premenstrual symptom load and T1-weighted MRI based brain measures of cortical thickness, volume, and surface area as well as subcortical volumes, not controlling for menstrual cycle phase. After corrections for multiple comparison, linear models including age revealed significant positive associations between premenstrual symptom load and the volume of the left posterior cingulate cortex. Item-level analyses confirmed that the association with overall symptom load were not driven by specific symptom domains. These findings partly overlap with previous brain morphological findings in individuals with PMS and could possibly represent a non-phase dependent correlate of premenstrual symptoms.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100916"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketamine treatment for depression in elderly inpatients: an observational case series","authors":"Benedikt Römer ,&nbsp;Stian Maroni ,&nbsp;Espen Fevang ,&nbsp;Henrik Bjørgaas Helle ,&nbsp;Lowan H. Stewart ,&nbsp;Dag Aarsland ,&nbsp;Audun Osland Vik-Mo","doi":"10.1016/j.jadr.2025.100904","DOIUrl":"10.1016/j.jadr.2025.100904","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment-resistant depression (TRD) in elderly patients is a challenging issue, with limited options beyond electroconvulsive therapy (ECT). Intravenous ketamine has emerged as a potential alternative, but its efficacy in older patients is not well-studied. This study evaluates the tolerability and efficacy of intravenous ketamine in 10 consecutively treated elderly patients mostly with TRD in an inpatient geriatric psychiatry setting.</div></div><div><h3>Methods</h3><div>Ten elderly patients (aged 61–77) mostly with TRD were treated with six bi-weekly intravenous ketamine infusions (0.5–1.0 mg/kg) as an add-on treatment in an open-label trial. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline, after two treatments, and after six treatments. Clinically significant improvement (≥25 % improvement), response (≥50 % improvement), and remission (MADRS &lt; 10) rates were calculated. Tolerability was monitored throughout.</div></div><div><h3>Results</h3><div>After six treatments, 7 out of 10 patients showed clinically significant improvement, with 5 meeting response criteria, and 2 achieving remission. The mean MADRS score reduction was 14.2 (SD = 9.62) for the entire sample. Those with ≥25 % improvement exhibited a rapid decrease in symptoms, with a mean MADRS score reduction of 14.14 (SD = 6.74) already after the second infusion. Only 2 of the 7 patients showed sustained benefit four weeks after treatment. The treatment was well-tolerated with no serious adverse events.</div></div><div><h3>Conclusion</h3><div>Intravenous ketamine rapidly reduced depressive symptoms in most patients, but the majority did not maintain the response at four-week follow-up. Further research is needed to develop strategies for maintaining the effects and to study larger samples.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100904"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-use transcranial direct current stimulation (tDCS) as a safe, effective, and feasible application in depression: A randomized, single-blind, placebo-controlled trial","authors":"Tuba Aktürk ,&nbsp;Mehmet Yücel Ağargün ,&nbsp;Sümeyye Özdemir ,&nbsp;Esra Dalmızrak ,&nbsp;Bahar Güntekin","doi":"10.1016/j.jadr.2025.100902","DOIUrl":"10.1016/j.jadr.2025.100902","url":null,"abstract":"<div><h3>Introduction</h3><div>Anodal transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (DLPFC) alleviates depression symptoms and enhances cognitive functions in major depressive disorder (MDD) patients. Previously, these outcomes were demonstrated primarily in clinical or laboratory settings through randomized placebo-controlled trials. Our objective was to assess the feasibility and effectiveness of asynchronously supervised, home-use tDCS on both mood and cognition in MDD patients, within a randomized, single-blind, placebo-controlled trial.</div></div><div><h3>Method</h3><div>Twenty MDD patients were randomized into active (<em>N</em> = 11) and sham (<em>N</em> = 9) tDCS groups. The protocol entailed daily 30-minute sessions at 2 mA with the anode over the left-DLPFC and the cathode over the right-DLPFC, conducted five days a week for three weeks. Sham stimulation consisted of a brief 30-second interval between 10-second ramp-up and down periods. After initial training, patients were administered tDCS at home and were evaluated using depression-related questionnaires and cognitive tests at baseline and post-intervention. Adherence and tolerance were asynchronously monitored via a remote supervision platform.</div></div><div><h3>Results</h3><div>High tolerability (adverse-event incidence rate of 0.63 %) and strong adherence (an average of 14.45 out of 15 sessions completed) were observed for home-use tDCS. The active group demonstrated significantly greater improvements in depression scores (BDI-II) and in cognitive performance (Digit Span tests), compared to the sham group, which received placebo treatment with the same protocol.</div></div><div><h3>Conclusion</h3><div>The results of our study demonstrate that home-use tDCS is feasible, safe and might be effective for patients with depression, offering a more accessible and cost-effective approach to neuromodulation treatments in mental health.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100902"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregivers’ burden and psychological distress in bipolar disorder in everyday clinical practice","authors":"Joannes W. Renes ,&nbsp;Ralph W. Kupka ,&nbsp;Willem A. Nolen ,&nbsp;Adriaan W. Hoogendoorn ,&nbsp;Eline J. Regeer","doi":"10.1016/j.jadr.2025.100903","DOIUrl":"10.1016/j.jadr.2025.100903","url":null,"abstract":"<div><h3>Introduction</h3><div>The effect of interventions involving caregivers of patients with bipolar disorder (BD) in everyday clinical practice has been understudied.</div></div><div><h3>Aim</h3><div>To investigate associations between the use of an emergency plan on emerging symptoms and participation in group psychoeducation versus burden and psychological distress experienced by caregivers, while controlling for patients’ severity of illness.</div></div><div><h3>Methods</h3><div>A nationwide naturalistic study on long-term outpatient treatment of BD, using self-report questionnaires about patients’ treatment and illness outcome, caregivers’ burden as measured with the core module of the Involvement Evaluation Questionnaire (IEQ), and caregivers’ psychological distress as measured with the General Health Questionnaire (GHQ-12).</div></div><div><h3>Results</h3><div>In total 777 dyads of patients and caregivers participated. Caregivers reported low levels of burden and psychological distress. Use of an emergency plan was associated with decreased level of caregivers’ burden (<em>p</em>=.014) and remained so (<em>p</em>=.003) when testing the independent association given the effect of group psychoeducation and controlling for patients’ severity of illness. No evidence was found for an effect on psychological distress. Participation in group psychoeducation was not associated with either outcome measure.</div></div><div><h3>Limitations</h3><div>The study used self-report questionnaires, and possibly included better functioning patients with a Dutch cultural background, and more resilient caregivers being mostly spouse or partner.</div></div><div><h3>Conclusions</h3><div>Use of an emergency plan was associated with less burden in caregivers of patients with BD. Longitudinal studies are needed to gain better insight in the effects of interventions on caregiver outcomes in BD.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"21 ","pages":"Article 100903"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and psychometric validation of the Italian version of the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS)","authors":"Giulio Emilio Brancati ,&nbsp;Lisa Ventura ,&nbsp;Alessandro Froli ,&nbsp;Samuele Gemignani ,&nbsp;Thomas E. Gift ,&nbsp;Barrie K. Marchant ,&nbsp;Giulio Perugi","doi":"10.1016/j.jadr.2025.100908","DOIUrl":"10.1016/j.jadr.2025.100908","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>In this study we developed and validated the Italian version of the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS), a clinician-rated scale for attention-deficit/hyperactivity disorder (ADHD) in adults. It assesses both observable behavior and subjective experiences and is tailored to address clinical features more directly relevant to adults with the disorder.</div></div><div><h3>Methods</h3><div>50 participants were recruited, including 32 referred to the Psychiatry Unit 2 at Pisa University Hospital, and 18 recruited through snowball sampling. 25 were diagnosed with ADHD, 15 with other psychiatric conditions, and 10 were healthy controls. All participants were evaluated using the WRAADDS and a set of clinician-rated, informant-rated and self-rated instruments. Psychometric characteristics of the WRAADDS were assessed, including inter-rater reliability and internal consistency, as well as concurrent and criterion validity.</div></div><div><h3>Discussion</h3><div>The WRAADDS total and composite domains score showed excellent inter-rater reliability (Spearman's <em>r</em> ≥ 0.815; <em>N</em> = 17) and internal consistency (Cronbach's α ≥ 0.88). Concurrent validity was supported by correlations with measures of inattention, hyperactivity/impulsivity, and emotional dysregulation (<em>r</em> ≥ 0.6). Patients with ADHD scored significantly higher than the other participants on several WRAADDS scores and an ADHD composite score ≥ 8 distinguished patients with ADHD with accuracy = 88 %, sensitivity = 92 %, and specificity = 84 %. In conclusion, the Italian version of the WRAADDS is a valid assessment tool for adult ADHD, facilitating a comprehensive understanding of the disorder within the adult population.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100908"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esketamine nasal spray compassionate use program in the Netherlands: An open label, multi-center cohort study in severe treatment-resistant depression","authors":"Abel (K.A.J.) Busz ,&nbsp;Emma (E.J.) Schmidt ,&nbsp;Rob (R.H.S.) van den Brink ,&nbsp;Karen (K.) Foeken ,&nbsp;Marasha (M.) de Jong ,&nbsp;Joost (J.B.C.) Mertens ,&nbsp;Martijn (M.S.) van Noorden ,&nbsp;Etienne (E.J.F.L.) Olivier ,&nbsp;Koen (K.R.J.) Schruers ,&nbsp;Sara (S.I.J.) Schutters ,&nbsp;Joris (J.) van Son ,&nbsp;Wessel (W.J.) Strootker ,&nbsp;Harry (H.C.P.) Venema ,&nbsp;Dieuwertje (D.A.) de Waardt ,&nbsp;Jasper (J.B.) Zantvoord ,&nbsp;Danielle (D.) Cath ,&nbsp;Henricus (H.G.) Ruhe","doi":"10.1016/j.jadr.2025.100905","DOIUrl":"10.1016/j.jadr.2025.100905","url":null,"abstract":"<div><h3>Background</h3><div>Esketamine, a N-methyl-<span>d</span>-aspartate (NMDA) receptor antagonist, used intranasally (IN), is applied as an antidepressant (AD) in treatment-resistant depressed (TRD) patients. Real-world studies with IN esketamine are still scarce.</div></div><div><h3>Objectives</h3><div>To evaluate the effectiveness and potential moderators of response of IN esketamine in real-world TRD patients treated in a compassionate use program (CUP) in the Netherlands.</div></div><div><h3>Method</h3><div>In this multi-center, open label, naturalistic cohort-study 42 patients were treated with 28–84 mg IN esketamine augmenting an oral AD. We used the Montgomery-Asberg rating scale (MADRS) change scores as primary outcome and report response-, remission rates and minimal clinically important difference (MCID) reached after 28 and 90 days of treatment. Potential effect moderators studied were level of treatment resistance and history of electroconvulsive therapy (ECT).</div></div><div><h3>Results</h3><div>Baseline mean MADRS score was 33.6 ± 5.3 and 64.3 % of the population had a history of ≥5 failed AD treatments. At 28 days, a significant decrease of 10.1 (7.3–12.6) MADRS-points was observed (Cohen's d 1.9, 95 % CI: 0.26–0.45, <em>t</em> = 7.20, <em>p &lt;</em> .001). Between 29 and 90 days no additional significant decrease in the MADRS score was observed. Response- and remission rates were 28.6 % and 14.3 % at 28 days and 35.7 % and 19.8 % at 90 days (<em>n</em> = 42), respectively. At 28 days 52.4 % achieved MCID. No clinically relevant moderating effects were found.</div></div><div><h3>Limitations</h3><div>Small sample size and variable time between screening and start of treatment.</div></div><div><h3>Conclusions</h3><div>In this group of TRD patients, IN esketamine treatment showed significant effectiveness, suggesting a valuable treatment option for this group.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100905"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}