Group, videoconference-delivered cognitive therapy, behavioral activation, and mindfulness meditation all produced medium-to-large reductions in pain interference for adults with chronic low back pain, with gains maintained at 3- and 6-month follow-ups. The three treatments showed similar effectiveness, with no significant differences between them except that behavioral activation improved sleep disturbance more than mindfulness meditation from pre- to post-treatment. Effect sizes for secondary outcomes were generally small to medium across all conditions. These findings indicate that telehealth-delivered psychological treatments are effective for chronic low back pain and can expand access to evidence-based care.
Intranasal esketamine plus an antidepressant reduced depression scores by about 3 points on the MADRS scale after 4 weeks, a statistically significant but small improvement that falls below the 6.5-point threshold for clinical significance used in the pivotal trials. A continuation trial showed reduced relapse risk, but a monotherapy trial had a larger effect with concerns about bias. Esketamine increased risks of sedation, dissociation, and other adverse events without increasing serious adverse events. No moderation by age or treatment resistance level was found. The clinical relevance of the benefit is unclear given the adverse event risks.
A meta-ethnography of eight qualitative studies examined how people with eating disorders and their providers experience psychedelic-assisted therapy. Five meta-themes emerged: core transformative processes (Mind-Body-Spirit, Emotional Processing) unfold within specific contextual conditions (Navigating Challenges and Risks, Enabling Safe and Supportive Experiences) and lead to meaningful outcomes (Therapeutic Improvements). Psychedelics may improve emotion processing and enhance perception of and connection with the body and self, which is pertinent to eating disorder recovery. However, low weight and physical vulnerabilities increase risks for adverse side effects. To achieve therapeutic outcomes, eating-disorder-specific contextual conditions are required, including dual competency in psychedelic treatment and eating disorder psychopathology.