Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials

Elizabeth D. Ballard, Kathleen Wills, Níall Lally, Erica Richards, David A. Luckenbaugh, Tessa Walls, Rezvan Ameli, Mark J. Niciu, Nancy E. Brutsche, Lawrence Park, Carlos A. Zarate

Research output: Contribution to journalArticle

Abstract

Background Identifying clinical correlates associated with reduced suicidal ideation may highlight new avenues for the treatment of suicidal thoughts. Anhedonia occurs across psychiatric diagnoses and has been associated with specific neural circuits in response to rapid-acting treatments, such as ketamine. This analysis sought to evaluate whether reductions in suicidal ideation after ketamine administration were related to reduced levels of anhedonia, independent of depressive symptoms. Methods This post-hoc analysis included treatment-resistant patients with either major depressive disorder (MDD) or bipolar disorder (BD) from several clinical trials of ketamine. Anhedonia was assessed using a subscale of the Beck Depression Inventory (BDI) and the Snaith-Hamilton Pleasure Scale (SHAPS). The outcome of interest was suicidal ideation, as measured by a subscale of the Scale for Suicide Ideation (SSI5), one day post-ketamine administration. Results Anhedonia, as measured by the SHAPS, was associated with suicidal thoughts independent of depressive symptoms both before and after ketamine administration. One day post-ketamine administration, improvements on the SHAPS accounted for an additional 13% of the variance in suicidal thought reduction, beyond the influence of depressive symptoms. The BDI anhedonia subscale was not significantly associated with suicidal thoughts after adjusting for depressive symptoms. Limitations Data were limited to patients experiencing a major depressive episode and may not be generalizable to patients experiencing an active suicidal crisis. Conclusions Suicidal thoughts may be related to symptoms of anhedonia independent of other depressive symptoms. These results have implications for the potential mechanisms of action of ketamine on suicidal thoughts.

Original languageEnglish (US)
Pages (from-to)195-200
Number of pages6
JournalJournal of Affective Disorders
Volume218
DOIs
StatePublished - Aug 15 2017
Externally publishedYes

Fingerprint

Anhedonia
Ketamine
Clinical Trials
Depression
Suicidal Ideation
Pleasure
Equipment and Supplies
Major Depressive Disorder
Bipolar Disorder
Mental Disorders
Suicide
Action Potentials
Therapeutics

Keywords

  • Anhedonia
  • Depression
  • Ketamine
  • RDoC
  • Suicide

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Ballard, E. D., Wills, K., Lally, N., Richards, E., Luckenbaugh, D. A., Walls, T., ... Zarate, C. A. (2017). Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials. Journal of Affective Disorders, 218, 195-200. https://doi.org/10.1016/j.jad.2017.04.057

Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials. / Ballard, Elizabeth D.; Wills, Kathleen; Lally, Níall; Richards, Erica; Luckenbaugh, David A.; Walls, Tessa; Ameli, Rezvan; Niciu, Mark J.; Brutsche, Nancy E.; Park, Lawrence; Zarate, Carlos A.

In: Journal of Affective Disorders, Vol. 218, 15.08.2017, p. 195-200.

Research output: Contribution to journalArticle

Ballard, ED, Wills, K, Lally, N, Richards, E, Luckenbaugh, DA, Walls, T, Ameli, R, Niciu, MJ, Brutsche, NE, Park, L & Zarate, CA 2017, 'Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials', Journal of Affective Disorders, vol. 218, pp. 195-200. https://doi.org/10.1016/j.jad.2017.04.057
Ballard, Elizabeth D. ; Wills, Kathleen ; Lally, Níall ; Richards, Erica ; Luckenbaugh, David A. ; Walls, Tessa ; Ameli, Rezvan ; Niciu, Mark J. ; Brutsche, Nancy E. ; Park, Lawrence ; Zarate, Carlos A. / Anhedonia as a clinical correlate of suicidal thoughts in clinical ketamine trials. In: Journal of Affective Disorders. 2017 ; Vol. 218. pp. 195-200.
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abstract = "Background Identifying clinical correlates associated with reduced suicidal ideation may highlight new avenues for the treatment of suicidal thoughts. Anhedonia occurs across psychiatric diagnoses and has been associated with specific neural circuits in response to rapid-acting treatments, such as ketamine. This analysis sought to evaluate whether reductions in suicidal ideation after ketamine administration were related to reduced levels of anhedonia, independent of depressive symptoms. Methods This post-hoc analysis included treatment-resistant patients with either major depressive disorder (MDD) or bipolar disorder (BD) from several clinical trials of ketamine. Anhedonia was assessed using a subscale of the Beck Depression Inventory (BDI) and the Snaith-Hamilton Pleasure Scale (SHAPS). The outcome of interest was suicidal ideation, as measured by a subscale of the Scale for Suicide Ideation (SSI5), one day post-ketamine administration. Results Anhedonia, as measured by the SHAPS, was associated with suicidal thoughts independent of depressive symptoms both before and after ketamine administration. One day post-ketamine administration, improvements on the SHAPS accounted for an additional 13{\%} of the variance in suicidal thought reduction, beyond the influence of depressive symptoms. The BDI anhedonia subscale was not significantly associated with suicidal thoughts after adjusting for depressive symptoms. Limitations Data were limited to patients experiencing a major depressive episode and may not be generalizable to patients experiencing an active suicidal crisis. Conclusions Suicidal thoughts may be related to symptoms of anhedonia independent of other depressive symptoms. These results have implications for the potential mechanisms of action of ketamine on suicidal thoughts.",
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N2 - Background Identifying clinical correlates associated with reduced suicidal ideation may highlight new avenues for the treatment of suicidal thoughts. Anhedonia occurs across psychiatric diagnoses and has been associated with specific neural circuits in response to rapid-acting treatments, such as ketamine. This analysis sought to evaluate whether reductions in suicidal ideation after ketamine administration were related to reduced levels of anhedonia, independent of depressive symptoms. Methods This post-hoc analysis included treatment-resistant patients with either major depressive disorder (MDD) or bipolar disorder (BD) from several clinical trials of ketamine. Anhedonia was assessed using a subscale of the Beck Depression Inventory (BDI) and the Snaith-Hamilton Pleasure Scale (SHAPS). The outcome of interest was suicidal ideation, as measured by a subscale of the Scale for Suicide Ideation (SSI5), one day post-ketamine administration. Results Anhedonia, as measured by the SHAPS, was associated with suicidal thoughts independent of depressive symptoms both before and after ketamine administration. One day post-ketamine administration, improvements on the SHAPS accounted for an additional 13% of the variance in suicidal thought reduction, beyond the influence of depressive symptoms. The BDI anhedonia subscale was not significantly associated with suicidal thoughts after adjusting for depressive symptoms. Limitations Data were limited to patients experiencing a major depressive episode and may not be generalizable to patients experiencing an active suicidal crisis. Conclusions Suicidal thoughts may be related to symptoms of anhedonia independent of other depressive symptoms. These results have implications for the potential mechanisms of action of ketamine on suicidal thoughts.

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