Over six months of routine esketamine treatment for treatment-resistant depression, depressive symptoms and daily functioning both improved progressively. By month six, 78.3% of patients showed a symptomatic response and 46.7% reached symptomatic remission, while 78.3% showed a functional response but only 33.3% achieved functional remission. Functional remission accumulated more slowly than symptomatic remission, with cumulative rates of 5% at one month, 15% at three months, and 33.3% at six months. Higher baseline disability and more previous antidepressant trials were linked to lower odds of functional remission at six months. The findings suggest that functional improvement follows a distinct trajectory from symptom improvement and should be monitored separately in treatment-resistant depression.
Cannabis use alters time perception in a dose-dependent manner, leading to time overestimation in preclinical studies and impaired time estimation and reproduction abilities in humans, along with subjective temporal fragmentation and depersonalization. These effects may stem from indirect dopaminergic action and structural, functional, and metabolic changes in the cerebello-thalamo-cortical circuit. Despite growing interest in time perception's role in psychiatry, few studies have examined the link between cannabis-induced timing alterations and psychiatric symptoms such as those in psychotic and mood disorders.