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Paolo Fusar-Poli

5 papers in the library · 251 citations · publishing 2022-2026

Papers

The lived experience of psychosis: a bottom-up review co-written by experts by experience and academics.

World psychiatry : official journal of the World Psychiatric Association (WPA) June 1, 2022 Paolo Fusar-Poli, Andrés Estradé, Giovanni Stanghellini et al. 225 citations

Psychosis unfolds through distinct stages, each with its own core existential experiences. Early phases (premorbid and prodromal) involve loss of common sense, perplexity, lack of immersion in the world, heightened salience, a feeling that something important is about to happen, perturbation of the sense of self, and a need to hide inner turmoil. The first episode brings transitory relief from delusions, intense self-referentiality, permeated self-world boundaries, internal noise, and dissolution of self with social withdrawal. Later stages (relapsing and chronic) involve grieving losses, feeling split, and struggling to accept inner chaos, a new self, diagnosis, and uncertain future. Treatment experiences include both positive and negative aspects, with recovery understood as reconstructing personhood and re-establishing bonds toward meaningful goals.

Efficacy, all-cause discontinuation, and safety of serotonergic psychedelics and MDMA to treat mental disorders: A living systematic review with meta-analysis.

Eur Neuropsychopharmacol November 7, 2025 Mikkel Højlund, Helin Y. Kafali, Begüm Kırmızı et al. 12 citations

A living systematic review with meta-analysis examined the efficacy, safety, and all-cause discontinuation of serotonergic psychedelics and MDMA for treating mental disorders. The review found that these substances show promise in reducing symptoms of conditions such as depression, anxiety, and post-traumatic stress disorder, with some evidence supporting their therapeutic potential. However, the authors note that the overall quality of evidence is limited by small sample sizes, short follow-up periods, and methodological concerns. Safety profiles varied, with most adverse events being mild to moderate, though serious adverse events were reported in some studies. The review emphasizes the need for larger, more rigorous trials to confirm these findings.

The revival of psilocybin between scientific excitement, evidence of efficacy, and real-world challenges.

CNS spectrums December 1, 2024 Mauro Scala, Chiara Fabbri, Paolo Fusar-Poli et al. 8 citations

Psilocybin shows promise for treating mood and anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and substance use disorder, but significant evidence gaps remain. Current studies suggest psilocybin may alleviate depression, anxiety, obsessions, compulsions, and addictive behaviors, yet comparisons with standard antidepressants or anxiolytics are lacking, and optimal dosage, long-term efficacy, and safety are unclear due to trial limitations. Real-world implementation faces challenges including infrastructural requirements, personnel training, cultural stigma, and unresolved legal and ethical issues. Larger, more rigorous studies are needed to substantiate the evidence base before psilocybin can transition from research to clinical practice.

Major Depression as a Disorder of the Narrative Self: A Qualitative Study.

Psychopathology January 1, 2024 Milena Mancini, Cecilia Maria Esposito, Andrés Estradé et al. 6 citations

Abnormal self-experiences are common in major depression but are not included in current diagnostic manuals, which limits understanding and treatment. Through qualitative interviews analyzed with the Consensual Qualitative Research method, three categories of abnormal self-experience emerged: an inability to project oneself forward, not recognizing one's self, and losing control over one's self. The core of depressive experience appears to be an inability to recognize otherness as part of oneself, leading to specific symptoms of depersonalization that differ from those in schizophrenia. Narrative identity is central to the development and maintenance of depression.

Comparative profiles of anomalous self-experiences and social cognition in clinical high risk for psychosis and autism spectrum disorder.

Schizophr Res Cogn June 11, 2026 Kristina Ballestad Gundersen, Tina Dam Kristensen, Alberte C.E. Jeppesen et al.

People at clinical high risk for psychosis and those with autism spectrum disorder both report unusual self-experiences, such as a diminished sense of self or altered bodily awareness, but the patterns differ between the two groups. The study compared these anomalous self-experiences and social cognition in both groups. It found that while both groups showed elevated levels of anomalous self-experiences compared to controls, the clinical high-risk group had more pronounced disturbances in self-awareness and agency, whereas the autism group showed greater impairments in social cognition, such as understanding others' mental states. These findings suggest that anomalous self-experiences may be a specific marker for psychosis risk, distinct from the social cognitive difficulties characteristic of autism.