Prucker, Teresa (2023) Vegetative symptoms predict the treatment outcome of repeated-dose oral esketamine assisted psychotherapy in treatment-resistant depression. Research Master thesis, Research Master.
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Abstract
Introduction: Repeated-dose ketamine assisted psychotherapy alongside treatment as usual was proposed as a novel treatment option for treatment-resistant depression. However, not all patients benefit from the treatment which might be due to interindividual differences in the presentation of depressive symptoms between patients with treatment-resistant MD. Determining for which patients this therapy might be effective is vital to prevent years of progressing illness and disability. Method: In a sample of 162 patients diagnosed with treatment-resistant unipolar or bipolar major depression (MD) treated with repeated-dose oral esketamine assisted psychotherapy alongside their usual treatment for 6 weeks, Multiple Logistic Regression was used to determine which symptom dimensions of MD predict treatment effectiveness. The symptom dimensions were mood and cognitive, anxiety and arousal and vegetative symptoms. In the main analysis treatment effectiveness was operationalized as the Minimally Clinically Important Difference (MCID = 27.1% reduction in depressive symptoms from baseline to end of treatment). Secondary analysis uncovered the predictive quality for response and remission. Results: Each one unit increase in vegetative symptoms significantly decreased the likelihood of the patient to reach the MCID by one fifth. The chance to reach response significantly decreased by one fifth for each unit increase in mood and cognitive symptoms. No symptom dimension significantly predicted remission. Discussion: Due to very low response and remission rates in the current study the results for the prediction of response and remission should be interpreted with utmost caution. General health should be considered as potentially confounding in the prediction of MCID for a low profile of vegetative symptoms. This study represents a step towards individualized treatment suggestions for ketamine assisted psychotherapy offering the potential for a more effective treatment of MD.
| Item Type: | Thesis (Research Master) |
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| Supervisor name: | Paap, M.C.S. and Enriquez Geppert, S. and Dalfsen, J.H. van and Schoevers, R.A. |
| Degree programme: | Research Master |
| Differentiation route: | Clinical Psychology and Clinical Neuropsychology [Research Master] |
| Date Deposited: | 26 Jul 2023 09:43 |
| Last Modified: | 26 Jul 2023 09:43 |
| URI: | http://gmwpublic.studenttheses.ub.rug.nl/id/eprint/2631 |
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