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The antidepressant effect of low-dose ketamine infusion on Taiwanese patients with anxious vs nonanxious treatment-resistant depression (ANX-TRD vs NANX-TRD) has remained unknown.
In total, 71 patients with TRD were randomized to three groups. Each group had participants who received saline infusions mixed with 0 (a normal saline infusion), 0.2, and 0.5 mg/kg of ketamine. Participants were followed up for 2 weeks. Anxious depression was defined as major depressive disorder with a total score of 7 or more on the 17-item Hamilton Depression Rating Scale Anxiety-Somatization factor. Generalized estimating equation models were used to investigate the effects of treatment (ketamine vs placebo) and depression type (ANX-TRD vs NANX-TRD) in the reduction of depressive symptoms during the follow-up period.
Patients with ANX-TRD were less likely to respond to a single low-dose ketamine infusion than those with NANX-TRD. Among patients with NANX-TRD, low-dose ketamine infusion was significantly superior to placebo for reducing depressive symptoms. However, among patients with ANX-TRD, ketamine was not superior to placebo; nonetheless, approximately 30% of the patients responded to ketamine infusion compared to 13% who responded to the placebo.
Low-dose ketamine infusion was effective for Taiwanese patients with NANX-TRD but not so effective for those with ANX-TRD. A higher level of anxiety severity accompanying depression was related to greater depression severity. This may confound and reduce the antidepressant effect of ketamine infusion.
The association between autoimmune diseases and schizophrenia has rarely
been systematically investigated.
To investigate the association between schizophrenia and a variety of
autoimmune diseases and to explore possible gender variation in any such
Taiwan's National Health Insurance Research Database was used to identify
10 811 hospital in-patients with schizophrenia and 108 110 age-matched
controls. Univariate and multiple logistic regression analyses were
performed, separately, to evaluate the association between autoimmune
diseases and schizophrenia. We applied the false discovery rate to
correct for multiple testing.
When compared with the control group, the in-patients with schizophrenia
had an increased risk of Graves' disease (odds ratio (OR) = 1.32, 95% CI
1.04–1.67), psoriasis (OR = 1.48, 95% CI 1.07–2.04), pernicious anaemia
(OR = 1.71, 95% CI 1.04–2.80), celiac disease (OR = 2.43, 95% CI
1.12–5.27) and hypersensitivity vasculitis (OR = 5.00, 95% CI
1.64–15.26), whereas a reverse association with rheumatoid arthritis (OR
= 0.52, 95% CI 0.35–0.76) was also observed. Gender-specific variation
was found for Sjögren syndrome, hereditary haemolytic anaemia, myasthenia
gravis, polymyalgia rheumatica and dermatomyositis.
Schizophrenia was associated with a greater variety of autoimmune
diseases than was anticipated. Further investigation is needed to gain a
better understanding of the aetiology of schizophrenia and autoimmune