A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression
Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on t...
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.608499/full |
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DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
Eduardo Jorge Muniz Magalhães Luciana Maria Sarin Lorena Catarina Del Sant Ana Cecília Lucchese Carolina Nakahira Marco Aurélio Tuena Camila Brito Puertas Victor Augusto Rodovalho Fava Rodrigo Simonini Delfino Rodrigo Simonini Delfino Juliana Surjan Juliana Surjan Matheus Souza Steglich Matheus Souza Steglich Matheus Ghossain Barbosa Guilherme Abdo José Alberto Del Porto José Alberto Del Porto Charles B. Nemeroff Hugo Cogo-Moreira Hugo Cogo-Moreira Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Andrea Feijo Mello Andrea Feijo Mello |
| spellingShingle |
Eduardo Jorge Muniz Magalhães Luciana Maria Sarin Lorena Catarina Del Sant Ana Cecília Lucchese Carolina Nakahira Marco Aurélio Tuena Camila Brito Puertas Victor Augusto Rodovalho Fava Rodrigo Simonini Delfino Rodrigo Simonini Delfino Juliana Surjan Juliana Surjan Matheus Souza Steglich Matheus Souza Steglich Matheus Ghossain Barbosa Guilherme Abdo José Alberto Del Porto José Alberto Del Porto Charles B. Nemeroff Hugo Cogo-Moreira Hugo Cogo-Moreira Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Andrea Feijo Mello Andrea Feijo Mello A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression Frontiers in Psychiatry child sex abuse treatment-resistant depression esketamine sex directed acyclic graph |
| author_facet |
Eduardo Jorge Muniz Magalhães Luciana Maria Sarin Lorena Catarina Del Sant Ana Cecília Lucchese Carolina Nakahira Marco Aurélio Tuena Camila Brito Puertas Victor Augusto Rodovalho Fava Rodrigo Simonini Delfino Rodrigo Simonini Delfino Juliana Surjan Juliana Surjan Matheus Souza Steglich Matheus Souza Steglich Matheus Ghossain Barbosa Guilherme Abdo José Alberto Del Porto José Alberto Del Porto Charles B. Nemeroff Hugo Cogo-Moreira Hugo Cogo-Moreira Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Acioly Luiz Tavares Lacerda Andrea Feijo Mello Andrea Feijo Mello |
| author_sort |
Eduardo Jorge Muniz Magalhães |
| title |
A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression |
| title_short |
A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression |
| title_full |
A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression |
| title_fullStr |
A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression |
| title_full_unstemmed |
A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression |
| title_sort |
clinical rationale for assessing the impact of childhood sexual abuse on adjunctive subcutaneous esketamine for treatment-resistant depression |
| publisher |
Frontiers Media S.A. |
| series |
Frontiers in Psychiatry |
| issn |
1664-0640 |
| publishDate |
2021-08-01 |
| description |
Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD).Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients.Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction.Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine. |
| topic |
child sex abuse treatment-resistant depression esketamine sex directed acyclic graph |
| url |
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.608499/full |
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doaj-b9638f2dcfc5465186e6869dc8fd3f862021-08-17T06:14:49ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-08-011210.3389/fpsyt.2021.608499608499A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant DepressionEduardo Jorge Muniz Magalhães0Luciana Maria Sarin1Lorena Catarina Del Sant2Ana Cecília Lucchese3Carolina Nakahira4Marco Aurélio Tuena5Camila Brito Puertas6Victor Augusto Rodovalho Fava7Rodrigo Simonini Delfino8Rodrigo Simonini Delfino9Juliana Surjan10Juliana Surjan11Matheus Souza Steglich12Matheus Souza Steglich13Matheus Ghossain Barbosa14Guilherme Abdo15José Alberto Del Porto16José Alberto Del Porto17Charles B. Nemeroff18Hugo Cogo-Moreira19Hugo Cogo-Moreira20Acioly Luiz Tavares Lacerda21Acioly Luiz Tavares Lacerda22Acioly Luiz Tavares Lacerda23Acioly Luiz Tavares Lacerda24Andrea Feijo Mello25Andrea Feijo Mello26Department of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilProgram for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilProgram for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilProgram for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilProgram for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Psychiatry and Behavioral Sciences, Institute of Early Life Adversity Research, Dell Medical School, University of Texas at Austin, Austin, TX, United StatesDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilDepartment of Education, ICT and Learning, Faculty of Teacher Education and Languages, Østfold University College, Halden, NorwayDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilProgram for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, BrazilLaboratory of Integrative Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, BrazilCNS Unit, BR Trials, São Paulo, BrazilDepartment of Psychiatry, Federal University of São Paulo, São Paulo, BrazilProgram for Research and Care on Violence and Post-traumatic Stress Disorder, Department of Psychiatry, Federal University of São Paulo, São Paulo, BrazilBackground: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD).Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients.Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction.Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.608499/fullchild sex abusetreatment-resistant depressionesketaminesexdirected acyclic graph |