Frontiers in psychiatry
January 1, 2024
Pablo Sabucedo, Oscar Andión, Robert A Neimeyer et al.
4 citations
A protocol describes a clinical trial testing whether ayahuasca-assisted Meaning Reconstruction therapy reduces prolonged grief symptoms more than therapy alone or no treatment. At least 69 people who lost a first-degree relative within the prior year and scored 40 or higher on the Texas Revised Inventory of Grief will be assigned to one of three groups: ayahuasca-assisted therapy, therapy alone, or no treatment. The therapy involves nine online sessions; the ayahuasca group also attends two group sessions with the substance. Grief severity, quality of life, post-traumatic growth, and other measures will be assessed at baseline, after treatment, and at three months. This is the first trial to empirically examine psychedelic-assisted psychotherapy for grief.
Frontiers in psychiatry
January 1, 2024
Aleksandra Kupferberg, Gregor Hasler
4 citations
Social cognitive deficits and impaired social behavior are common in major depressive disorder and harm quality of life and recovery. Standard treatments like antidepressants, psychotherapies, and brain stimulation show mixed results for improving social functioning, with some limitations and side effects. Newer treatments such as intranasal oxytocin, mindfulness-based cognitive therapy, and psychedelic-assisted psychotherapy have demonstrated positive effects on social cognition and behavior by modulating self-referential processing, empathy, emotion regulation, and enhancing neuroplasticity. Animal models reveal underlying neurobiological mechanisms. Future research should explore combining treatments and investigate long-term outcomes and individual differences.
Frontiers in psychiatry
January 1, 2024
Magdalena Więdłocha, Piotr Marcinowicz, Jan Komarnicki et al.
4 citations
Borderline personality disorder (BPD) occurs in 10-30% of patients with major depressive disorder (MDD), and over 80% of individuals with BPD also have MDD. This comorbidity leads to more severe depression, greater functional impairment, higher treatment resistance, and increased suicidality. While ketamine effectively treats treatment-resistant depression (TRD), existing studies often did not exclude people with BPD, suggesting benefits may extend to those with both conditions. However, no protocols specifically address this comorbidity, and psychotherapeutic interventions crucial for lasting effects have been omitted.
Frontiers in psychiatry
January 1, 2024
Valentin Max Vetter, Tobias Kurth, Stefan Konigorski
4 citations
A planned series of N-of-1 trials will evaluate whether a short daily breathwork or mindfulness exercise reduces perceived stress in physicians in residence in Germany. Each participant will choose between box breathing and a guided mindfulness-based breathing exercise, then be randomly assigned to alternating one-week intervention and control phases over four weeks. Daily stress levels will be self-reported via a smartphone app. The study aims to determine if these easy-to-implement interventions can lower work-related stress, potentially reducing treatment errors and improving doctor-patient relationships.
Frontiers in psychiatry
January 1, 2024
Christopher P Harris, Becky Jones, Kathryn Walker et al.
4 citations
A 29-year-old man with bipolar disorder, Autism Spectrum Disorder, and type 2 diabetes experienced daily mood swings, suicidal thoughts, and anger outbursts that could not be controlled by prescribed medications. He underwent ketamine assisted psychotherapy with 6 initial IV infusions over one month followed by 2 booster infusions. After treatment, dramatic reductions in outbursts, anxiety, suicidality, and depression scores were observed. The case suggests that Autism Spectrum Disorder is not a contraindication for IV ketamine and ketamine assisted psychotherapy, and that such treatment might be tailored to individuals with both conditions, though additional systematized research is warranted.
Frontiers in psychiatry
January 1, 2022
Udo Bonnet, Michael Specka, Ann-Kristin Kanti et al.
4 citations
Substance-dependent users and addiction medicine experts rank the harms of traditional illicit drugs (heroin, cocaine, amphetamines) highest, with alcohol and benzodiazepines also in a top-harm tier. Both groups place methadone, nicotine, and cannabis in the midrange, and buprenorphine and psychotropic mushrooms at the lowest harm level. Users rate the benefits of traditional illicit drugs, cannabis, and nicotine more positively than experts do, while experts judge methadone as significantly less harmful than users do. Users attribute the most benefits to buprenorphine, methadone, and cannabis, likely reflecting that over 50% of the user sample sought opiate detoxification treatment. The findings inform psychoeducation and policy debates.
Frontiers in psychiatry
January 1, 2022
Arij Yehya, Salma M Khaled, Iris E C Sommer et al.
4 citations
Psychotic-like experiences (hallucinations or delusions below the threshold of a disorder) are common in the general population. In interviews with 12 female undergraduate students in Qatar, these experiences were prevalent. Students' descriptions showed that culture and religion shaped the types of hallucinations and some delusions they reported. Many students normalized their experiences and linked them to real-life events, possibly as a defense against the stigma of mental illness and being labeled abnormal.
Frontiers in psychiatry
January 1, 2025
Seok-In Yoon, Hui-Yeong Park, Chan Park et al.
3 citations
Mindfulness and Qigong Training for Self-Healing (MQT-SH) significantly reduced symptoms of Hwabyung, depression, anxiety, and anger while increasing subjective vitality in patients diagnosed with both Hwabyung and depressive disorder. In a randomized controlled trial with 64 participants, those who received MQT-SH for six weeks showed improvements maintained at a six-week follow-up. Physical vitality mediated the effect on Hwabyung, while psychological vitality mediated the effect on depression. Only one adverse event was reported, indicating the intervention is safe. Home practice was not significantly linked to changes. The findings suggest MQT-SH is an effective and safe intervention for these conditions.
Frontiers in psychiatry
January 1, 2024
Gianna Capodilupo, Raymond Blattner, Anita Must et al.
3 citations
In clinical trials of rapid-acting antidepressants for treatment-resistant depression, the Montgomery-Åsberg Depression Rating Scale (MADRS) is commonly used to track symptom changes. This study analyzed item-level score changes across 733 subjects over 10 visits and compared them with a survey of 75 raters on which items they found most helpful for assessing change. The items 'Reduced sleep', 'Apparent sadness', and 'Pessimistic thoughts' showed the greatest average score change per visit, while raters ranked 'Reported sadness', 'Lassitude', and 'Apparent sadness' as most helpful. This discrepancy may stem from difficulty assessing certain items, the novel treatment's effects, or raters' familiarity with traditional antidepressants.
Frontiers in psychiatry
January 1, 2024
Seok-In Yoon, Hui-Yeong Park, Hyun Woo Lee et al.
3 citations
Hwabyung, a Korean culture-bound syndrome involving anger-related symptoms, frequently co-occurs with depressive disorder. For such patients, combined treatment addressing both conditions is important. Mindfulness and Qigong may help regulate emotions like depression, anxiety, and anger. This planned trial will test whether Mindfulness and Qigong Training for Self-Healing (MQT-SH) improves emotional problems in patients with both Hwabyung and depressive disorder. It is a two-arm block randomized controlled trial recruiting 64 participants. The experimental group will receive MQT-SH for six weeks while the control group receives no treatment; then the control group will receive MQT-SH for ethical equity. Outcomes include Hwabyung, depression, anxiety, anger, and vitality, measured at baseline, 6 weeks, and 12 weeks.
Frontiers in psychiatry
January 1, 2024
René Zeiss, Melissa Schweizer, Bernhard Connemann et al.
3 citations
Two cases of rhabdomyolysis, a destruction of muscle tissue with elevated creatine kinase levels, occurred after administration of nasal esketamine for treatment-resistant depression. A 33-year-old male patient developed muscle pain and fatigue after the fourth dose, with creatine kinase levels above 22,000 U/L. A 22-year-old male patient exhibited muscle weakness and elevated creatine kinase levels (8,032 U/L) after the tenth dose. In both cases, creatine kinase levels returned to normal after discontinuation of esketamine and supportive care. The temporal connection suggests a possible causal relationship. No prior literature on esketamine-induced rhabdomyolysis following nasal administration was found.
Frontiers in psychiatry
January 1, 2024
Aakash Sathappan, Benjamin Yudkoff
3 citations
Ketamine, which has rapid antidepressant and anti-suicidal effects in adults, is now being considered for adolescents with treatment-resistant depression and suicidality. Obtaining informed consent for this treatment poses unique challenges: clinicians must balance an adolescent's growing autonomy with parental consent, address the drug's potential to induce psychedelic-like effects, and highlight its off-label use and the uncertainty about repeated exposure on the developing brain. The paper also discusses scenarios where parents consent but the adolescent refuses, and alternative treatments like transcranial magnetic stimulation and electroconvulsive therapy. Adherence to informed consent principles is paramount to uphold ethical standards amid ongoing research.
Frontiers in psychiatry
January 1, 2024
Albino J Oliveira-Maia, Benoît Rive, Yordan Godinov et al.
3 citations
About 10-30% of people with major depressive disorder have treatment-resistant depression (TRD), and most do not respond to real-world treatments. An indirect comparison of two studies found that after six months, patients with TRD who received esketamine nasal spray plus an antidepressant had a 25.6% probability of achieving functional remission, measured by a Sheehan Disability Scale score of 6 or less, compared to an adjusted 11.5% probability for those receiving real-world treatments. This represents a relative risk of 2.226. Across both groups, patients who did not achieve clinical response or remission had low probabilities of functional remission (5.84% and 8.76%, respectively), while those who did had higher probabilities (43.
Frontiers in psychiatry
January 1, 2024
Delphine Yeh, Sylvain Penaud, Alexandre Gaston-Bellegarde et al.
3 citations
Disturbances in the minimal Self—the basic, pre-reflective sense of embodied experience—are linked to episodic memory impairments in first-episode psychosis (FEP). In a pilot study using immersive virtual reality, 10 FEP patients and 35 matched healthy controls experienced a full-body illusion with either synchronous or asynchronous visuomotor stimulation to induce strong or weak embodiment. Under strong embodiment, FEP patients performed significantly worse than controls in recognizing contextual information, though their retrieval phenomenology ratings were similar. Under weak embodiment, FEP patients performed similarly to controls in contextual recognition but rated retrieval phenomenology significantly lower. Higher schizotypy in controls correlated with a diminished sense of Self and poorer episodic memory. The findings suggest that targeting minimal Self-disorders may improve episodic memory and psychosocial outcomes in schizophrenia spectrum disorders.
Frontiers in psychiatry
January 1, 2024
Jonathan Martin Flintoff, Suzy Alexander, James Paul Kesby et al.
3 citations
Cognitive flexibility, the ability to adapt behavior to changing rules, is impaired in schizophrenia and predicts functional outcomes, yet antipsychotics do not improve it. A novel dynamic strategy shifting task (DSST) was optimized in operant chambers for rats, requiring a minimum of 6 correct consecutive responses to switch between spatial and non-spatial rules. Testing 84 Sprague Dawley rats with acute ketamine (0, 3, 10 mg/kg) showed fewer premature and more perseverant responses to initiate trials. Ketamine significantly improved reversal of a non-spatial visual discrimination rule but had no effect on spatial visual or response discrimination rules. The DSST provides a rapid assay for distinct forms of cognitive flexibility relevant to neuropsychiatric conditions.
Frontiers in psychiatry
January 1, 2024
Xuan Liu, Yidan Zhang, Hongxin Cheng et al.
3 citations
Mindfulness-Based Relapse Prevention (MBRP) training improved trait mindfulness and reduced psychological craving in methamphetamine-dependent young adult females. In a randomized trial with 58 participants from a compulsory isolation drug rehabilitation center, those who received 2-hour MBRP sessions twice weekly for 4 weeks, alongside routine treatment, showed greater increases in mindfulness scores and greater decreases in craving scores compared to a control group receiving routine treatment alone. Mental feedback monitoring also showed significant improvements in concentration and relaxation during breath meditation and body scan exercises. The findings suggest MBRP can be an effective addition to standard treatment for this population.
Frontiers in psychiatry
January 1, 2023
Karl Kristjan Kaup, Madis Vasser, Kadi Tulver et al.
3 citations
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Frontiers in psychiatry
January 1, 2022
Przemysław Zakowicz, Maria Skibińska, Joanna Pawlak
3 citations
Adolescents with early-onset schizophrenia spectrum disorders make more errors on a task measuring language embodiment than healthy peers, and this deficit does not improve after 6-8 weeks of standard treatment. More errors are linked to auditory hallucinations, while abnormal beliefs are associated with different clinical measures. The findings suggest that a disrupted connection between thinking and environmental stimuli—termed language disembodiment—may contribute to psychosis symptoms, supporting a phenomenological approach to diagnosis.
Frontiers in psychiatry
January 1, 2025
Muneeb Hashmi, Padmasini Mugunthan, Priyal Jain et al.
2 citations
A patient with treatment-resistant depression and psychogenic non-epileptic seizures (functional seizures) experienced resolution of both conditions after receiving esketamine, a drug approved for treatment-resistant depression and major depressive disorder with suicidal thoughts. The report discusses the potential therapeutic effects of esketamine on functional seizures beyond its antidepressant properties.
Frontiers in psychiatry
January 1, 2025
Peter Gasser, Matthias E Liechti, Friederike Holze
2 citations
A 64-year-old man with traumatic life experiences and neuropathic pain from chemotherapy was treated with LSD and MDMA. Initial 200 µg LSD doses produced no acute effects, but 400 µg doses led to subjective effects and lasting therapeutic benefits. Switching to MDMA—both high doses (150-175 mg) and repeated low doses (12.5-25 mg)—resulted in marked improvements in neuropathic pain that persisted after treatment stopped. MDMA mini/microdosing has not been widely studied; this case documents benefits of low-dose MDMA for pain disorders, though further research is needed.
Frontiers in psychiatry
January 1, 2025
Ella van Beers, Irene de Vries, Caroline Planting et al.
2 citations
Many people with eating disorders have a history of childhood maltreatment or trauma, yet few studies have tested treatments that address both conditions together. This systematic review of 11 studies found that biological interventions—including repurposed medications, ketamine, repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation, electroconvulsive therapy, MDMA, and neurofeedback—all showed some improvement in eating disorder or trauma symptoms. The strongest effects were seen with rTMS and MDMA. However, missing data and selective reporting limited the reliability of these findings, and adverse events were common. More research is needed on combined treatments for this complex patient group.
Frontiers in psychiatry
January 1, 2025
Jian-Qiang Tan, Li-Mei Gu, Yan-Ling Zhou et al.
2 citations
Patients with depression and a higher baseline body mass index (BMI) experienced greater reductions in depressive symptoms after six intravenous ketamine infusions compared with those with a lower baseline BMI. In a study of 135 patients (103 with major depressive disorder, 32 with bipolar depression), those with a lower BMI (under 26) showed a significantly higher response rate after the first infusion (40.3% vs. 23.6%), but this difference disappeared by the sixth infusion. The overall change in depression scores over time differed significantly between the groups, with the higher-BMI group showing greater improvement. The findings are from an exploratory, post-hoc analysis of an open-label, single-arm trial.
Frontiers in psychiatry
January 1, 2025
Dimitri Perivoliotis, Kayla Knopp, Shannon Remick et al.
2 citations
Set and setting—the mindset a person brings to therapy and the environment in which it occurs—are foundational to MDMA-assisted therapy for PTSD and critically influence its efficacy. Drawing on experience conducting clinical trials in the Veterans Health Administration, this article describes advantages and challenges of implementing this intervention in large healthcare systems. Specific, practical suggestions are offered for optimizing set and setting from both participant and clinician perspectives, aiming to leverage opportunities and adapt to challenges. These recommendations are intended to inform future research and potential clinical implementation efforts in traditional healthcare settings.
Frontiers in psychiatry
January 1, 2025
Ezioma Gbujie, Lisa Vercollone, Joji Suzuki
2 citations
A 72-year-old man hospitalized for hematuria developed severe opioid withdrawal when buprenorphine/naloxone was initiated. Two high-dose attempts failed, and standard symptom-relief medications did not help. A single intravenous 27 mg bolus of ketamine briefly improved symptoms but caused emergence delirium, treated with haloperidol. The patient was eventually stabilized on buprenorphine/naloxone 8 mg twice daily. The case suggests ketamine may be an effective adjunct for managing opioid withdrawal, but its use on general medical floors carries risks such as delirium, warranting further safety research.
Frontiers in psychiatry
January 1, 2025
Qijing Liu, Ying Liu, Qian Fu et al.
2 citations
Postoperative sleep disturbance (PSD) is a common complication after surgery, caused by personal, intraoperative, postoperative, and environmental factors, and it impairs recovery and long-term prognosis. Esketamine, a non-competitive NMDA receptor antagonist and the dextrorotatory isomer of ketamine, has stronger receptor affinity, more significant analgesic effects, and better safety than ketamine. Beyond its sedative, analgesic, and antidepressant properties, emerging evidence suggests esketamine may improve PSD through various mechanisms, though existing research results remain controversial. This article reviews the latest research progress on esketamine for improving PSD, discussing its clinical efficacy and potential mechanisms to guide perioperative anesthesia management and postoperative rehabilitation.