Di Nicola Marco, Pepe Maria, d'Andrea Giacomo, Marcelli Ilaria, Pettorruso Mauro, Andriola Ileana, Barlati Stefano, Carminati Matteo, Cattaneo Carlo Ignazio, Clerici Massimo, De Berardis Domenico, De Filippis Sergio, Dell'Osso Bernardo, Di Lorenzo Giorgio, Maina Giuseppe, Manchia Mirko, Marcatili Matteo, Martiadis Vassilis, Niolu Cinzia, Petralia Antonino, Rosso Gianluca, Serafini Gianluca, Signorelli Maria Salvina, Vannucchi Tommaso, Vismara Matteo, Zanardi Raffaella, Vita Antonio, Sani Gabriele, Martinotti Giovanni
Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy.
J Pers Med. 2025 Apr 21;15(4):161. doi: 10.3390/jpm15040161.
. Treatment-resistant depression (TRD) is a prevalent, high-burden disorder. Esketamine nasal spray (ESK-NS) has been approved for, T.R.D.; and efficacy has been observed in both clinical trials and real-world studies. However, observations integrating patients' perspective on this treatment are limited. This multicentric Italian study explored experiences with ESK-NS in TRD patients, focusing on perceived therapeutic effects and overall satisfaction. . A self-report survey was administered to 236 outpatients with TRD (55.1% females, 54.1 ± 14.1 years) treated with ESK-NS for at least three consecutive months within standard clinical care. Based on satisfaction levels, participants were classified as "unsatisfied" (10.2%), "partially satisfied" (19.1%), "satisfied" (44.4%), or "very satisfied" (26.3%), and compared for sociodemographic, clinical characteristics, and feedback on perceived benefits. Artificial intelligence (OpenAI) served to categorize responses to an open-ended question. . Enhanced quality of life was reported by 88.4% of participants. Significant differences emerged in earliest self-perceived benefits, most relevant effects, and impact on global functioning across groups. Specifically, "very satisfied" patients described the following: early improvements in depressed mood, suicidal thoughts, and restlessness; decreased suicidal thoughts among the most significant effects; and functional gains across all domains. OpenAI identified experiences of personal growth and rediscovery and a desire for tailored settings and approaches as recurring topics. . Most patients reported a positive perception of ESK-NS treatment. The most satisfied participants highlighted significant benefits to depressed mood, suicidal thoughts, and overall functioning. Patient-reported experiences offer insights into different psychopathological dimensions, including functional outcomes and quality of life. Integrating these perspectives into clinical practice might assist treatment personalization, improving patients' adherence and satisfaction.
难治性抑郁症（TRD）是一种常见的、负担沉重的疾病。艾氯胺酮鼻喷雾剂（ESK-NS）已被批准用于治疗TRD；在临床试验和真实世界研究中均观察到了其疗效。然而，整合患者对这种治疗的看法的观察结果有限。这项多中心意大利研究探讨了TRD患者使用ESK-NS的体验，重点关注感知到的治疗效果和总体满意度。
对236名接受ESK-NS治疗至少连续三个月的TRD门诊患者（55.1%为女性，年龄54.1±14.1岁）进行了一项自我报告调查，这些患者处于标准临床护理中。根据满意度水平，参与者被分为“不满意”（10.2%）、“部分满意”（19.1%）、“满意”（44.4%）或“非常满意”（26.3%），并对其社会人口统计学、临床特征以及对感知益处的反馈进行比较。利用人工智能（OpenAI）对一个开放式问题的回答进行分类。
88.4%的参与者报告生活质量得到改善。在最早感知到的益处、最相关的效果以及对各亚组整体功能的影响方面出现了显著差异。具体而言，“非常满意”的患者描述如下：情绪低落、自杀念头和烦躁不安的早期改善；自杀念头减少是最显著的效果之一；以及在所有领域的功能改善。OpenAI确定个人成长和重新发现的经历以及对个性化环境和方法的渴望是反复出现的主题。
大多数患者对ESK-NS治疗持积极看法。最满意的参与者强调了对情绪低落、自杀念头和整体功能的显著益处。患者报告的经历为不同的精神病理维度提供了见解，包括功能结果和生活质量。将这些观点整合到临床实践中可能有助于治疗的个性化，提高患者的依从性和满意度。
