Grant: DRA : Canada Graduate Research Scholarship - Doctoral Program (CGRS D)

Major Depressive Disorder (MDD) affects 1 in 10 Canadians at some point in their lifetime, and 1 in 25 Canadians experience a depressive episode each year. People with MDD often experience feelings of hopelessness, loss of interest, and disturbances in sleep and appetite. Many people find relief after using first-line antidepressant medications. However, several key studies in the area have found such improvements in symptoms to be largely attributed to patients expecting positive outcomes instead of the improvements resulting from how the medicine actually works in the body. This phenomenon is commonly referred to as the placebo response resulting from high expectations. While the placebo response reduces symptoms of depression, these improvements are often short-lasting, as positive expectations do not treat the biological mechanisms underlying MDD. As such, it is important for clinicians to know the extent of a medication's effectiveness that is caused by how well the medicine works in the body rather than the placebo response. In recent years, psychedelics such as psilocybin and ketamine have received a lot of positive media coverage and "hype" as rapid-acting and highly effective treatments for depression. As such, many patients that elect to receive these treatments usually have high positive expectations for them to be effective. During the course of my PhD, I will evaluate the role of patient expectations and their respective outcomes to treatments of ketamine and psilocybin for depression, and examine how these factors change brain activity patterns, across a variety of settings. Looking at patients receiving these substances within a private outpatient ketamine facility and clinical trials on both substances, we believe the results of this project will provide valuable insights into the various dimensions of patient expectations and their influence on the effectiveness of ketamine and psilocybin treatments for depression.