Mindfulness, music, visual occlusion in ketamine therapy for depression: do they change outcomes? A qualitative and quantitative analysis of a randomized controlled trial
Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany; with the National Institute of Mental Health and the University of Pittsburgh
How they used Delve
Psychiatry researchers at Jena University Hospital, the National Institute of Mental Health, and the University of Pittsburgh used Delve to double-code 36 open-ended participant accounts of ketamine infusion in a randomized controlled trial, reporting intercoder agreement of Cohen's kappa = 0.78 for a thematic analysis of how mindfulness, music, and an eye mask changed the experience.
“Systematic coding procedures were used to enhance rigor and reliability despite these constraints, including a pre-defined thematic coding framework, iterative refinement, independent double-coding with adjudication, and calculation of intercoder agreement (Cohen’s κ = 0.78, indicating substantial agreement). Responses were stored securely and analyzed using Delve software (available at: https://delvetool.com/blog/codebook-qualitative-content-analysis).”
- Field
- Psychiatry and psychopharmacology; subjective experience of antidepressant-dose ketamine infusion with combined sensory intervention
- Data
- Open-ended written descriptions of the infusion experience collected 30 days post-infusion from 36 of 43 randomized participants with unipolar depressive disorder (19 of 22 in the combined sensory intervention arm, 17 of 21 controls), alongside MADRS and other clinician-rated and self-report scales
- Approach
- Braun and Clarke's six-stage thematic framework applied collaboratively within a randomized controlled trial: a pre-defined thematic coding framework, iterative refinement, independent double-coding with adjudication, and intercoder agreement reported as Cohen's kappa = 0.78; member checking and test-retest were deliberately forgone to avoid unblinding and reconstruction of an acute experience
- Data types
- Open-ended survey responses
Abstract
Introduction: This is the first randomized controlled trial to use both qualitative and quantitative methods to evaluate the effects of a combined sensory intervention that included mindfulness, music, and a light-occluding eye mask during antidepressant-dose ketamine treatment for depression. Methods: Forty-three participants with unipolar depressive disorder enrolled in the study; 22 individuals were randomly assigned to receive mindfulness, music, and eye mask during ketamine infusion, and 21 individuals in the control group received only ketamine without additional interventions. Quantitative analyses assessed the impact of combined sensory intervention on ketamine’s antidepressant effects, and qualitative analyses explored the participants’ experiences. Results: Depression scores improved significantly and similarly across both groups. However, adding combined sensory interventions to ketamine infusion enriched subjective experience. More participants in the combined sensory intervention group reported deeper engagement, a stronger sense of connection to reality, increased focus on the experience rather than the strangeness of it, moments of relief from sadness, and feelings of awe and spiritual insight compared to the control group. Four individuals in the combined sensory intervention group also reported discomfort. Discussion: Ketamine’s antidepressant effects remained consistent with or without combined sensory intervention; however, mindfulness, music, and eye mask made the experience more meaningful and emotionally rich for many, though it also introduced discomfort for a few-this outcome might be avoided by making these interventions optional. Given the limited research on combining ketamine with sensory interventions, these results contribute valuable insights and underscore the need for further studies to explore this combined therapeutic approach. Clinical trial registration: https://clinicaltrials.gov/study/NCT05168735, identifier NCT05168735.
Citation
Mina Kheirkhah, Nastasia Mcdonald, Julia Aepfelbacher, Manivel Rengasamy, Sharvari Shivanekar, Crystal Spotts, Iya Cooper, Andrew Baumeister, Elizabeth Bell, Kevin Do-Nguyen, Mary L. Woody, Shabnam Hossein, Ioline D. Henter, Allison C. Nugent, Nadia S. Hejazi, Hamidreza Jamalabadi, Mani Yavi, Martin Walter, Carlos A. Zarate, Rebecca B. Price (2025). Mindfulness, music, visual occlusion in ketamine therapy for depression: do they change outcomes? A qualitative and quantitative analysis of a randomized controlled trial. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2025.1642025