The lancet. Psychiatry
April 1, 2024
Jessica Niamh Harding, Noham Wolpe, Stefan Peter Brugger et al.
43 citations
A modified version of predictive coding, called hybrid predictive coding, provides a better model of how healthy people make inferences about external reality than standard predictive coding does. This more comprehensive model offers a richer understanding of psychosis, particularly the phenomenology of delusions, compared with standard predictive coding accounts. The authors describe the hybrid predictive coding model and suggest it could serve as a powerful new framework for computational psychiatric approaches to psychosis. They also propose directions for future work to formalize this perspective.
The lancet. Psychiatry
October 1, 2023
Gustavo C Medeiros, Malcolm Matheson, Isabella Demo et al.
38 citations
A systematic review of 69 neuroimaging studies (1751 participants) found no well-replicated biomarker for ketamine's antidepressant response, but identified several promising candidates. Response to ketamine was associated with post-treatment increases in gamma power in frontoparietal regions, increased functional connectivity within the prefrontal cortex, and increased functional activation of the striatum. The review highlights substantial methodological heterogeneity across studies and calls for further investigation of these biomarkers.
The lancet. Psychiatry
January 1, 2025
Carolina Seybert, Nina Schimmers, Lucio Silva et al.
26 citations
Reporting on the psychological intervention component of psychedelic-assisted psychotherapy is mostly incomplete and inconsistent across studies, limiting replicability and clinical translation. A systematic review of 45 original studies on psilocybin, MDMA, LSD, or ayahuasca for mental disorders found that descriptions of psychotherapy varied widely and completeness of information was generally low, based on an adapted Template for Intervention Description and Replication checklist. Studies involving MDMA showed more homogeneous psychotherapy and more procedural details. Improved reporting on psychological interventions would support replicability, generalisability, and accurate interpretation of research, as well as enhance feasibility and safety of future clinical research and real-world implementation.
The lancet. Psychiatry
June 1, 2025
Thorsten Barnhofer, Barnaby D Dunn, Clara Strauss et al.
9 citations
About half of patients with depression who complete the UK National Health Service Talking Therapies stepped care pathway still have symptoms. A randomized trial tested whether adding mindfulness-based cognitive therapy (MBCT) via videoconference to treatment as usual improves outcomes for these patients. At 34 weeks, the MBCT group had significantly lower depression scores than the treatment-as-usual group (adjusted difference -2.49 points on the PHQ-9). The MBCT group also had slightly lower healthcare costs and higher quality-of-life scores, with a 99% chance of being cost-effective at the £20,000 per QALY threshold. No serious adverse events occurred. MBCT is an effective and scalable further-line treatment for depression that does not remit after psychological therapy.
The lancet. Psychiatry
February 1, 2026
Rosa Ritunnano, Jeannette Littlemore, Barnaby Nelson et al.
8 citations
Delusions in first-episode psychosis are not isolated symptoms but emerge from a global shift in how a person experiences self and world, shaped by early negative emotions like shame. In a qualitative study of ten adults, persecutory, reference, and grandiose or religious themes were common and overlapping. Narrative interviews revealed that recurrent shame, anger, and fear, along with efforts to avoid or immerse in these emotions, preceded delusions. Three emotional transformation patterns were identified: from embodied shame to invincibility, from meaninglessness to love and hope, and feeling cut off in a simulation. Delusions reflect an embodied, temporal process where bodily experiences link to extreme appraisals, such as being a bad person or connected to God. Interventions should target the lived body and social environments for emotional regulation.
The lancet. Psychiatry
March 1, 2026
Jasper Feyaerts, Pavan S Brar, Louis Sass et al.
1 citation
Psychiatric research has long sought to identify and treat people in the early stages of psychosis, but progress has been limited. This paper argues that combining dynamical systems theory with the phenomenological self-disturbance model of schizophrenia can improve understanding and prediction of psychosis. The integration specifies causal processes involving altered self-awareness and reality-awareness, whose dynamics can be modeled to anticipate the onset and recurrence of psychotic episodes. This approach may enable earlier, personalized therapeutic interventions. Empirical testing of the model requires intensive longitudinal studies and phenomenological assessment methods. The authors also discuss theoretical and methodological challenges to implementing their proposal.