Psychopathology
January 1, 2024
Pietro Sarasso, Martina Billeci, Irene Ronga et al.
18 citations
Dissociative experiences from ketamine, often seen as undesirable side effects, may be essential for its antidepressant action in certain depression subtypes. The 'relaxed prior hypothesis' proposes that ketamine enhances sensitivity to bodily signals by blocking glutamate, improving short-term plasticity. Two patients with 'depersonalized depression' (Entfremdungsdepression) in a six-month esketamine program showed that induced dissociation, particularly disembodiment, could suspend ingrained patterns of feeling and behavior. This creates a window of psychological plasticity, allowing the body to regain responsiveness to emotional cues. The findings suggest esketamine's dissociative effects may be especially beneficial for those with compromised interoceptive awareness and interaffectivity.
Frontiers in psychology
January 1, 2023
Stefano Goretti, Cecilia Maria Esposito, Gilberto Di Petta
5 citations
Psychiatric urgency involves serious mental suffering and behavioral change requiring prompt treatment, while emergency is life-threatening. Although phenomenological psychopathology has neglected this area, the phenomenological method is essential for clinical management. The manuscript explores the phenomenological perspective of psychiatric emergencies, emphasizing the centrality of the encounter between clinician and patient as two subjects, not just doctor and patient. The affective space of intersubjectivity and intercorporeality enables transformative understanding. The emergency room atmosphere—full of haste, anxiety, and expectation—hinders authentic encounter, which must be recovered for diagnosis and therapy. Clinicians should immerse themselves in the patient's life-world, using the phenomenological method to grasp the crisis's meaning and help re-inscribe it within the patient's history.
Transl Psychiatry
October 31, 2025
Giacomo D’andrea, Stefania Chiappini, Laura Ciavoni et al.
3 citations
Psychedelics and ketamine/esketamine show promise for treating depressive disorders by inducing rapid and sustained antidepressant effects. The review examines their biological mechanisms, including modulation of glutamate and serotonin systems, promotion of neuroplasticity, and changes in brain connectivity and network function. Neuroimaging studies reveal alterations in default mode network, fronto-limbic connectivity, and thalamic activity. Clinical changes are associated with these brain alterations, though the precise relationships remain under investigation. The work synthesizes current evidence on how these compounds produce observable brain changes and symptom improvement, highlighting the need for further research to clarify mechanisms and optimize therapeutic applications.
The Journal of nervous and mental disease
September 1, 2024
Valerio Ricci, Giuseppe Maina, Gilberto Di Petta et al.
Substance-induced psychosis, especially from cannabis and cocaine, can transition to persistent psychosis, with cannabis posing a particularly high risk. Differences exist between substance-induced and primary psychotic disorders, and external factors play a key role. A phenomenological perspective describes this as a disruption in perception, altering time and space and causing hallucinations. The concept of a "twilight state" of consciousness helps explain the shift from substance use to psychosis, affecting spatiality, intersubjectivity, and temporality. This challenges standard diagnostic models and calls for a more nuanced understanding of how substances trigger psychotic experiences.