ArticleFrontiers in psychiatry2025
Personalizing esketamine treatment in TRD and TRBD: the role of mentalization, cognitive rigidity, psychache, and suicidality.
Article in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- (Es)ketamine in functional neurological disorder: a systematic review.Frontiers in psychiatry · 2026Pooled it
- Sleep Quality, Psychological Resilience, and Attachment Dimensions in Women with Unexplained and Male Factor Infertility: A Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Triglyceride-glucose-related indices and cardiovascular disease and mortality among individuals with depression: a prospective study from UK Biobank.Frontiers in nutrition · 2026Article
- The neurobiological synergy of transcranial magnetic stimulation and mindfulness-based interventions in treatment-resistant depression: a narrative review.Frontiers in psychiatry · 2026Review
- Baseline working memory was associated with improvement in psychological quality of life in patients with persistent depressive symptoms: a prospective observational study.Frontiers in psychiatry · 2026Article
- Sex as a moderator of the relationship between childhood trauma and depression in adulthood: an analysis in a clinical sample of adult patients.Frontiers in psychiatry · 2026Article
- Ketamine as a potential cognitive enhancer in neurological disorders: evidence from preclinical and clinical studies.Frontiers in neurologyReview
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Treatment-Resistant Depression (TRD) remains a major challenge in the management of Major Depressive Disorder (MDD). Esketamine, the S-enantiomer of ketamine and a glutamatergic modulator, was approved by the FDA and EMA for TRD in 2019. Beyond its rapid antidepressant effects, esketamine may enhance neuroplasticity, facilitating the reconnection with emotional and cognitive processes, improving mentalization and social cognition, and promoting resilience. Objective: This prospective multicenter observational study aimed to evaluate esketamine's therapeutic impact on both depressive symptoms and key psychological factors-including mentalization, psychache, social cognition, suicidality, and cognitive-emotional rigidity-that could predict treatment response and enable a more personalized approach to TRD and TRBD management. Methods: Thirty-six treatment-resistant depressive episode patients, including TRD and TRB, treated with esketamine were assessed over a six-month follow-up period using psychometric measures of depression severity, suicidality, mentalization, social cognition, psychache, and cognitive-emotional rigidity. Results: A significant improvement in depressive symptoms was observed, as indicated by a reduction in Montgomery-Åsberg Depression Rating Scale (MADRS) scores over time. Moreover, improvement was observed in different key psychological domains, such as mentalization, psychache, social cognition, suicidality, and cognitive-emotional rigidity. By six months, 69% of patients achieved remission, confirming a robust and sustained therapeutic response. Conclusions: These findings highlight the importance of a personalized treatment approach in treatment- resistant depressive episode patients. Esketamine may be particularly beneficial in reducing cognitive rigidity, improving mentalization, and breaking the cognitive inflexibility that contributes to sustained negative depressive thinking patterns. Further research is needed to refine patient stratification and optimize treatment strategies for individuals with treatment-resistant depressive episode patients.
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