Background

Interest and activity are part of the positive mood domain. Evidence suggests the symptom domain of interest-activity at baseline as a clinical predictor for treatment response to traditional antidepressants. However, whether this domain is related to the response to a single low-dose ketamine infusion remains unclear.

Methods

Seventy-one patients with treatment-resistant depression were randomized to 3 treatment groups: a single 0.5 or 0.2 mg/kg ketamine or normal saline placebo infusion. Depressive symptoms were measured using the 17-item Hamilton Depression Rating Scale before infusions and at postinfusion period (at 40 min and up to 2 weeks). Low (mild) versus medium versus high (severe) interest-activity symptom domain groups were classified on the basis of the cutoff point of ± 0.4 standard deviation. The effect of baseline interest-activity symptoms on outcomes was tested using generalized estimating equation models.

Results

The interest-activity symptom domain as a continuous variable (β = 8.413, p = .016) was related to the trajectory of depressive symptoms. Stratified by levels of the interest-activity symptom domain, in the low interest-activity, 0.2 mg/kg ketamine infusion (β = 0.013) demonstrated the greatest antidepressant effect (p < .01) compared with 0.5 mg/kg ketamine (β = 0.739) and placebo infusions; however, in the high interest-activity, 0.5 mg/kg ketamine infusion (β = 0.001) demonstrated the best antidepressant effect (p < .01) compared with 0.2 mg/kg ketamine (β = 1.372) and placebo infusions.

Discussion

The symptom domain of interest-activity was an independent predictor for the treatment response to a single low-dose ketamine infusion.

中文翻译：

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兴趣活动症状严重程度可预测对难治性抑郁症中氯胺酮输注的反应

背景

兴趣和活动是积极情绪领域的一部分。有证据表明，基线时有兴趣活动的症状域可作为对传统抗抑郁药治疗反应的临床预测指标。但是，该域是否与对单次低剂量氯胺酮输注的反应有关。

方法

将71例具有抗药性的抑郁症患者随机分为3个治疗组：一次0.5或0.2 mg / kg氯胺酮或生理盐水安慰剂输注。在输注前和输注后（40分钟至2周），使用17项汉密尔顿抑郁量表对抑郁症状进行测量。低（轻度）对中（高）对重度（重度）症状域组的分类基于临界点±0.4标准偏差。使用广义估计方程模型测试了基线兴趣活动症状对预后的影响。

结果

兴趣-活动症状域作为连续变量（β  = 8.413，p  = .016 ）与抑郁症状的轨迹有关。由兴趣活性症状域的水平分层，在低兴趣的活性，0.2毫克/千克氯胺酮输注（β  = 0.013）表现出最大的抗抑郁作用（p 与0.5mg / kg的氯胺酮（相比<.01）β  = 0.739）和安慰剂输注；但是，在高兴趣活动中， 与0.2 mg / kg氯胺酮（β  = 1.372）和安慰剂输注相比，0.5 mg / kg氯胺酮输注（β  = 0.001）表现出最佳的抗抑郁作用（p <.01）。

讨论区

兴趣活动的症状域是对单次小剂量氯胺酮输注治疗反应的独立预测因子。