General hospital psychiatry
January 1, 2025
Max Wolff, Hans Rutrecht, Gerhard Gründer et al.
9 citations
As psychedelic treatments move from research settings into hospitals, clinics, and community practices, a new competencies framework outlines the skills needed for safe, effective, and ethically sound therapy. The framework is substance-unspecific and transtheoretical, covering foundational domains including psychotherapy, biomedicine, philosophy, socio-cultural awareness, existential concerns, legal issues, and self-experience. It translates these into practical competencies for multi-professional cooperation, screening, preparation, dosing, integration, and harm-reduction. Developed within the MIND Foundation's Augmented Psychotherapy Training program, the framework awaits systematic evaluation but offers an initial blueprint for future accredited certification and clinician training as these treatments enter mainstream care.
General hospital psychiatry
July 24, 2025
Shizhen Wang, Mengru Wu, Jixiang Wei et al.
6 citations
Electronic mindfulness-based cognitive therapy (eMBCT) reduces anxiety and depression in adults with small but significant effects that are sustained over time. A meta-analysis of 12 randomized controlled trials with 2,588 participants found that eMBCT lowered anxiety (standardized mean difference -0.33) and depression (-0.34) compared to usual care, waitlist, or active interventions. Greater baseline symptom severity was linked to larger improvements. Short- and long-term benefits were observed, but medium-term effects were not significant. The findings suggest eMBCT is an effective scalable treatment, though further research is needed to enhance medium- and long-term outcomes and tailor interventions for flexible patient care.
General hospital psychiatry
January 1, 2025
Shizhen Wang, Wangjie Xia, Jian Zhang et al.
6 citations
A meta-analysis of 10 randomized controlled trials with 1314 cancer patients found that internet-based mindfulness interventions reduce anxiety and depression. The interventions were most effective when sessions lasted under 45 minutes and the program duration was within 8 weeks. Therapist-guided interventions, especially those with synchronous online interaction, produced greater improvements than unguided ones. The analysis reports moderate effect sizes for both anxiety and depression. The authors note that medium- to long-term efficacy requires further validation through high-quality research.
General hospital psychiatry
January 1, 2024
Mina Ansari, Brian Pittman, Daniel S Tylee et al.
6 citations
Blood pressure increases during ketamine infusion for depression, peaking at 40 minutes with average rises of 16.0 mmHg systolic and 11.0 mmHg diastolic. Severe hypertension occurred in 12.5% of patients and 0.98% of infusion sessions, most often during the first three treatments. Older age and a history of hypertension were associated with larger blood pressure surges, indicating that careful cardiovascular monitoring is needed, especially for these patients.
General hospital psychiatry
July 3, 2025
Kush V Bhatt, James D Asuncion, Al Alam et al.
4 citations
Classical psychedelics show therapeutic promise for mental health conditions, but their acute subjective effects—while possibly enhancing outcomes—also pose clinical challenges. This review examines the phenomenology, benefits, risks, and implementation issues tied to these subjective experiences. Emerging research on nonhallucinogenic analogues may preserve neuroplastic benefits without inducing intense subjective effects. The authors argue that a debate over the necessity of acute subjective effects may be avoidable, and clinical psychiatry should accommodate both approaches. Future research should explore both the role of subjective experience and alternative compounds to expand treatment options.
General hospital psychiatry
June 6, 2025
Daniel Villiger
4 citations
Questioning the necessity of embedding psychedelic use in psychotherapy, this paper examines cost pressures that could limit access to psychedelic-assisted therapy (PAT). It reviews evidence for the therapeutic and ethical importance of the patient-therapist relationship in PAT, then argues that shortening the preparation phase—a likely cost-saving measure—risks weakening that relationship. Three strategies are proposed to preserve the therapeutic bond under financial constraints: retaining relational elements during preparation, ensuring the same therapist works across all phases, and, when feasible, involving the patient's regular therapist.
General hospital psychiatry
January 1, 2024
Jeong Hoo Lee, Joji Suzuki
4 citations
For patients with catatonia who do not fully respond to standard treatments like benzodiazepines or electroconvulsive therapy (ECT), NMDA receptor antagonists may offer an alternative. A review of 37 articles found that amantadine (27 cases) and memantine (20 cases) were the most commonly reported agents, often showing quick responses when used alone or alongside benzodiazepines. Ketamine and esketamine were used successfully in a small number of cases (5 cases). These medications may be viable options when benzodiazepines are contraindicated, such as when delirium is present, or when ECT is unavailable or poorly tolerated. Further research is needed to confirm these findings.
General hospital psychiatry
January 1, 2025
Yvan Beaussant, Elise Tarbi, Kabir Nigam et al.
3 citations
Psilocybin-assisted therapy (PAT) is promising for cancer-related depression, but little is known about how the therapeutic context affects patient experiences. In interviews with 28 patients with cancer and depression who participated in a clinical trial, participants described the psilocybin experience as intense and demanding. Therapeutic benefits were closely tied to their ability to "surrender"—accepting and remaining open to the experience's intensity and unpredictability. A safe, supportive, and ethical environment was critical for trust and engagement. Preparation and integration were key to maximizing benefit. Music played a variable role, sometimes enhancing and other times distracting. The clinical setting provided safety, while ceremonial elements added meaning.
General hospital psychiatry
January 1, 2026
David T Kryszajtys, Carol J Strike, Brian Rush et al.
1 citation
Desperation for relief from persistent depression and anxiety, after standard treatments fail, shapes how people decide to self-treat with psychedelics. Analyzing 108 Reddit discussion threads, members who expressed desperation described a tipping point where worsening mental health and frustration with conventional care made relief feel urgent. This urgency led to rapid, unplanned self-treatment with psychedelics, often without researching options or using harm reduction, despite acknowledged risks. Some reported relief, while others linked worsening mental health to multiple desperation-driven decisions. These interpretations may inform clinical psychedelic models, where access is often granted after other treatments fail, and similar urgency may influence engagement and outcomes.
General hospital psychiatry
January 1, 2026
Rebeca Cohen, João Bastos, Catarina Cunha et al.
1 citation
A case series of 12 patients with treatment-resistant depression treated with a novel protocol combining ketamine injections (0.5-1.5 mg/kg intramuscularly, 5-8 sessions) and brief psychodynamic psychotherapy found that 67% responded and 58% achieved remission. Half of the patients maintained remission at 3-month and 1-year follow-ups. Ego dissolution during the third ketamine session correlated with symptom improvement and psychological insight. The results suggest that combining ketamine with psychotherapy may enhance and prolong antidepressant effects beyond ketamine alone.
General hospital psychiatry
January 1, 2026
Gabrielle F M Lovell, Shreya Vasudeva, Diana K Orsini et al.
Ketamine, an anesthetic also used for mood and anxiety disorders, may cause mild, temporary elevations in liver enzymes, but serious liver damage appears rare. A systematic review of 13 studies (5 randomized trials, 3 observational studies, and 5 case reports) involving 1,017 patients—mostly with major depressive disorder or bipolar disorder—found 75 mild liver enzyme elevations across trials, with only a few cases of impaired liver function. No cases met Hy's Law criteria for severe drug-induced liver injury. Case reports described more severe liver issues that improved with dose reduction or stopping treatment. Routine liver monitoring during ketamine treatment remains advisable.