Background

Comorbid borderline personality disorder and major depressive disorder is common and often not adequately responsive to standard antidepressant therapies. Ketamine is a potentially life-saving option.

Methods

153 adult patients with MDD were assessed with the Personality Assessment Inventory (PAI) Borderline Subscale. Data was normally distributed with a mean + SD of 38.95 + 11.54. Patients >1 SD above the mean were assigned to the MDD + BF group. All others were assigned to the MDD–BF group. Patients were administered IV ketamine 0.5 mg/kg of ketamine over 40 min. Mood was assessed using the Beck Depression Inventory-II at baseline, 3 and 24 h post-ketamine. Scores between the MDD + BF and MDD–BF group at each time point were compared using t-test or analysis of covariance (ANCOVA) model. The primary outcome was response at 24 h.

Results

The LS mean change in BDI at 24 h was −23.8 (15.3) for MDD + BF and −21.0 (13.5) for MDD–BF (F [1151] = 0.043, p = 0.51). The LS mean change in BDI at 3 h was −21.3 (13.2) for MDD + BF and −19.6 (13.2) for MDD–BF (F[1151] = 0.045, p = 0.83). The LS mean change in BDI at 14 days was −23.2 (15.3) for MDD + BF and −15.3 (15.2) for MDD–BF (F[1130] = 4.24, p = 0.04).

Limitations

People in the MDD + BF group were not necessarily diagnosable with borderline personality disorder.

Conclusions

These data indicate that IV ketamine is effective in MDD patients with and without elevated borderline features. This can provide clinicians some reassurance about using ketamine in this population.

中文翻译：

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静脉注射氯胺酮对重度抑郁症和边缘性人格障碍特征增强的患者的影响

背景

边缘性人格障碍和重度抑郁症共病很常见，并且通常对标准抗抑郁治疗没有充分的反应。氯胺酮是一种可能挽救生命的选择。

方法

使用人格评估量表 (PAI) 边缘子量表对 153 名成年 MDD 患者进行了评估。数据呈正态分布，平均值 + 标准差为 38.95 + 11.54。高于平均值 >1 SD 的患者被分配到 MDD + BF 组。所有其他人都被分配到 MDD-BF 组。患者在 40 分钟内静脉注射氯胺酮 0.5 mg/kg。使用贝克抑郁量表-II 在基线、服用氯胺酮后 3 小时和 24 小时对情绪进行评估。使用t检验或协方差分析 (ANCOVA) 模型比较 MDD + BF 和 MDD–BF 组在每个时间点的得分。主要结果是 24 小时的反应。

结果

MDD + BF 的 24 小时 BDI LS 平均变化为 -23.8 (15.3)，MDD–BF 的 LS 平均变化为 -21.0 (13.5)（F [1151] = 0.043，p = 0.51）。3 小时时，MDD + BF 的 BDI LS 平均变化为 -21.3 (13.2)，MDD–BF 的 LS 平均变化为 -19.6 (13.2)（F[1151] = 0.045，p = 0.83）。14 天时，MDD + BF 的 BDI LS 平均变化为 -23.2 (15.3)，MDD–BF 的 LS 平均变化为 -15.3 (15.2)（F[1130] = 4.24，p = 0.04）。

局限性

MDD + BF 组的人不一定可以诊断为边缘型人格障碍。

结论

这些数据表明静脉注射氯胺酮对于患有或不患有边缘特征升高的重度抑郁症患者均有效。这可以为临床医生在该人群中使用氯胺酮提供一些保证。