AUTHOR=Magalhães Eduardo Jorge Muniz , Sarin Luciana Maria , Del Sant Lorena Catarina , Lucchese Ana Cecília , Nakahira Carolina , Tuena Marco Aurélio , Puertas Camila Brito , Rodovalho Fava Victor Augusto , Delfino Rodrigo Simonini , Surjan Juliana , Steglich Matheus Souza , Barbosa Matheus Ghossain , Abdo Guilherme , Del Porto José Alberto , Nemeroff Charles B. , Cogo-Moreira Hugo , Lacerda Acioly Luiz Tavares , Mello Andrea Feijo
TITLE=A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression
JOURNAL=Frontiers in Psychiatry
VOLUME=12
YEAR=2021
URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.608499
DOI=10.3389/fpsyt.2021.608499
ISSN=1664-0640
ABSTRACT=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.