ArticleJournal of affective disorders2025
Baseline perceived stress as a predictor of ketamine/esketamine treatment response in treatment-resistant depression.
Article in Journal of affective disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Hepatic Safety of Ketamine and Esketamine for Treatment-Resistant Depression: A Real-World Cohort Study.Journal of clinical psychopharmacology · 2026Article
- Early suicidal ideation change and suicidality-associated emergency department utilization after ketamine or esketamine treatment in treatment-resistant depression.Therapeutic advances in psychopharmacology · 2026Article
- Ketamine Reduces Suicidality-Associated Emergency Department Utilization in Patients With Treatment-Resistant Depression: A 6-Month Mirror-Image Study.The Journal of clinical psychiatry · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundChronic stress is a risk factor for depression and may contribute to treatment resistance. This historical cohort study examined the association between baseline perceived stress, measured with the Perceived Stress Scale (PSS), and response to (es) ketamine in treatment-resistant depression (TRD).
methodAdult TRD patients who received intravenous racemic ketamine or intranasal esketamine were included. Depression symptoms were evaluated using the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR). Baseline stress was assessed using the PSS, with scores categorized into low to moderate (PSS < 27) and high (PSS ≥ 27) stress. Statistical tests, including Pearson correlation, Fisher's exact test, and Kruskal-Wallis tests, were used to explore associations between baseline stress, remission (QIDS-SR ≤ 5), and the number of treatments required for remission. Firth's logistic regression model estimated odds ratios (ORs) and 95 % confidence interval (CI).
resultsAmong 39 patients (median age 47, 61.5 % female), 66.7 % had high perceived stress. Patients with high PSS scores required more treatments for remission (median = 3 vs. 1, p = 0.04). Each 5-point PSS increase reduced remission odds by 60 % (OR = 0.40, 95 % CI: 0.14-0.81, p = 0.009), adjusting for stimulant use. Notably, these effects were independent of baseline depression severity. LIMITATIONS: The study's observational design and lack of a placebo group limit the findings.
conclusionsTRD patients with high baseline perceived stress had lower odds of remission, and required more treatments to achieve remission. Further research should investigate whether stress-reduction strategies combined with ketamine could enhance treatment outcomes and whether responses differ between acute and chronic perceived stress.
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