Frontiers in Psychiatry (Aug 2021)
A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression
- 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
Affiliations
- Eduardo Jorge Muniz Magalhães
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Luciana Maria Sarin
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Lorena Catarina Del Sant
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Ana Cecília Lucchese
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Carolina Nakahira
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Marco Aurélio Tuena
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Camila Brito Puertas
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Victor Augusto Rodovalho Fava
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Rodrigo Simonini Delfino
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Rodrigo Simonini Delfino
- Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Juliana Surjan
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Juliana Surjan
- Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Matheus Souza Steglich
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Matheus Souza Steglich
- Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Matheus Ghossain Barbosa
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Guilherme Abdo
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- José Alberto Del Porto
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- José Alberto Del Porto
- Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Charles B. Nemeroff
- Department of Psychiatry and Behavioral Sciences, Institute of Early Life Adversity Research, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Hugo Cogo-Moreira
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Hugo Cogo-Moreira
- Department of Education, ICT and Learning, Faculty of Teacher Education and Languages, Østfold University College, Halden, Norway
- Acioly Luiz Tavares Lacerda
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Acioly Luiz Tavares Lacerda
- Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Acioly Luiz Tavares Lacerda
- Laboratory of Integrative Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Acioly Luiz Tavares Lacerda
- CNS Unit, BR Trials, São Paulo, Brazil
- Andrea Feijo Mello
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Andrea Feijo Mello
- Program for Research and Care on Violence and Post-traumatic Stress Disorder, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- DOI
- https://doi.org/10.3389/fpsyt.2021.608499
- Journal volume & issue
-
Vol. 12
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.
Keywords
