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Frontiers in psychiatry

ISSN 1664-0640

114 papers in the library · 928 citations · publishing 2019-2026

Papers

Effect of mindfulness group therapy on maternal psychological distress and perinatal outcomes in twin pregnancy: a randomized controlled trial.

Frontiers in psychiatry January 1, 2025 Ying Zhou, Zai-Mei Tang, Lin Mei et al. 2 citations

An online mindfulness group therapy program for women with twin pregnancies prevented worsening of postpartum depression symptoms, improved mindfulness, and reduced perceived stress. The randomized controlled trial assigned 120 women to either six weekly 120-minute mindfulness sessions or usual care. Among the 109 who completed the intervention, those in the mindfulness group showed lower postpartum depressive symptoms and a lower incidence of low birth weight in their infants. The benefits held even when accounting for participants who did not finish the full study. The findings suggest that group mindfulness interventions integrated into prenatal care can help mitigate depression and stress in women expecting twins.

Brain stimulation enhances dispositional mindfulness in PTSD: an exploratory sham-controlled rTMS trial.

Frontiers in psychiatry January 1, 2025 Kaveh Rayani, Andrea Grabovac, Peter Chan et al. 2 citations

In a pilot trial, 31 adults with PTSD received either real or sham repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex. Mindfulness scores, measured by the Five Facet Mindfulness Questionnaire, did not improve significantly immediately after treatment when corrected for multiple comparisons. However, by three months after treatment, those who received real rTMS showed significant gains in total mindfulness and nonreactivity. The delayed improvement suggests the benefits of rTMS on dispositional mindfulness may take time to emerge. The findings indicate that brain stimulation might eventually help reduce PTSD-related suffering by boosting mindfulness.

Hepatic injury and hepatic failure adverse events in 3,4-methylenedioxymethamphetamine users reported to the FDA Adverse Event Reporting System.

Frontiers in psychiatry January 1, 2024 Tigran Makunts, Ruben Abagyan 2 citations

MDMA, currently being studied as a treatment for PTSD, is extensively metabolized by the liver, raising concerns about rare but serious drug-induced liver injury (DILI). While clinical trials have not measured liver injury markers or observed DILI symptoms, analysis of over 1,500 reports from the FDA Adverse Event Reporting System identified 23 cases of hepatic injury or failure where MDMA was taken with other substances. Twenty-two of those cases involved other drugs with known DILI concern, and only one report listed MDMA as the primary suspect. Given nearly 20 million annual doses of MDMA, this single report is insufficient to establish a significant association with DILI.

Dissociation and recovery in psychosis - an overview of the literature.

Frontiers in psychiatry January 1, 2024 Claudia Calciu, Rob Macpherson, Sui Yung Chen et al. 2 citations

No existing research directly links dissociation and recovery from psychosis. A systematic review of 2110 articles found only 19 that met inclusion criteria, and none of those conceptualized or hypothesized a relationship between dissociation and recovery from a psychotic episode. This gap indicates the topic remains unstudied. The review synthesizes international research on the phenomenology of dissociation, psychosis, and recovery separately, charting a direction for future investigation.

Rapid reduction of suicidal ideation with transient dissociative and "drunken gait" symptoms after intranasal esketamine, with music intervention: a case report.

Frontiers in psychiatry January 1, 2026 Haihua Tian, Zongfeng Zhang, Yan He et al. 1 citation

A 19-year-old woman with treatment-resistant depression and multiple suicide attempts received two courses of intranasal esketamine. During the first course, she experienced transient dissociative symptoms lasting about 55 minutes, including depersonalization and a 'drunken gait.' Patient-selected music reduced anxiety and disorientation, and prophylactic oxazepam prevented later mild dissociative episodes. By the end of treatment, suicidal ideation had resolved. The case suggests that dissociative reactions to esketamine are typically self-limiting and manageable, and that music intervention may help by modulating prefrontal-amygdala circuits and autonomic regulation.

Case Report: Repeated low doses of psilocybin reduce perceived symptom severity but fail to restore cognitive flexibility in a case of severe obsessive-compulsive disorder: an observational case study of identical twins.

Frontiers in psychiatry January 1, 2026 Sivert Drange, Jacob Cohen, Sys Stybe Johansen et al. 1 citation

In identical twins discordant for obsessive-compulsive disorder, the affected twin self-administered low doses of psilocybin (1–5 mg every third day) while the unaffected twin did not. The affected twin reported notable reductions in OCD symptoms, improved emotional regulation, and better well-being. However, cognitive flexibility, measured with a set-shift task, remained impaired compared to the unaffected twin. Low-dose psilocybin may alleviate some OCD symptoms but does not fully address underlying cognitive deficits.

Case Report: Intranasal esketamine combined with a form of generative artificial intelligence in the management of treatment-resistant depression.

Frontiers in psychiatry January 1, 2025 Alexandre Fraichot, Sophie Favre, Hélène Richard-Lepouriel 1 citation

A 37-year-old patient with treatment-resistant depression received intranasal Esketamine (84 mg) and used ChatGPT-4 to generate images and interpretations of his dissociative experiences, supported by a nurse. Depression severity was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS). The patient achieved remission, with MADRS scores declining by 50% by the third session and indicating mild depression or euthymia in the eight subsequent sessions. The patient reported that the artificial intelligence-generated images and interpretations helped him create a timeline of his experiences. The case report suggests combining intranasal Esketamine with generative artificial intelligence may be effective, but further research is needed.

A guided internet-delivered mindfulness-based cognitive therapy for insomnia: study protocol for a randomized controlled study.

Frontiers in psychiatry January 1, 2025 Zixuan Zeng, Fei Liu, Chenyi Zhu et al. 1 citation

Chronic insomnia disorder affects many people and is usually treated with cognitive behavioral therapy (CBT-I), but about 20% of patients do not respond well. Mindfulness may improve CBT-I outcomes, and mindfulness-based cognitive therapy (MBCT) has shown effectiveness for insomnia. This protocol describes a planned two-armed, parallel-group randomized controlled trial with 80 Chinese adults who have chronic insomnia. Participants will be randomly assigned to either a therapist-guided internet-based MBCT for insomnia (iMBCT-I) program or a sleep hygiene education program. Assessments occur at baseline, week 8 (end of intervention), and week 20 follow-up, with insomnia severity at week 8 as the primary outcome. This is the first test of therapist-guided iMBCT-I for chronic insomnia.

Research trends in esketamine for depression over the past decade: a bibliometric analysis.

Frontiers in psychiatry January 1, 2025 Baozhou Zhang, Yifan Liu, Jinwei Zheng et al. 1 citation

Research on esketamine for depression has surged from 2015 to 2024, totaling 925 articles, with 286 published in 2024 alone. The United States contributed the most publications (308), followed by China (260) and Canada (114). Leading journals include the Journal of Affective Disorders, Frontiers in Psychiatry, and the International Journal of Neuropsychopharmacology. Key authors are McIntyre, Roger S (52 publications), Hashimoto, Kenji (49), and Rosenblat, Joshua D (41). Prominent research keywords over the last decade are "treatment-resistant depression," "efficacy," "antidepressant," and "suicidal ideation." Current focus remains on assessing long-term safety, while a large disparity in research resources persists between developed and low- and middle-income countries.

Rapid treatment center for depression in China: constructive reflections and transnational implications.

Frontiers in psychiatry January 1, 2025 Zhan-Ming Shi, Xing-Bing Huang, Yan-Ling Zhou et al. 1 citation

China's National Health Commission prioritizes early diagnosis and standardized treatment of major depressive disorder (MDD). Rapid treatment centers across the country use electroconvulsive therapy (ECT), intravenous ketamine/esketamine, esketamine nasal spray, magnetic seizure therapy (MST), and Stanford Neuromodulation Therapy (SNT). This policy and practice review examines the strengths and shortcomings of these techniques in China, noting their potential to accelerate recovery. The findings offer insights for other countries and regions adopting rapid antidepressant strategies.

Virtual reality and psychedelics: new perspectives and new possibilities in the treatment of alcohol use disorder.

Frontiers in psychiatry January 1, 2025 Scott Matthews, Antonino Greco, Clara Rastelli et al. 1 citation

Virtual reality simulations of psychedelic phenomenology can replicate neurophysiological and behavioral markers of classic serotonergic psychedelics in healthy subjects, suggesting they may serve as an adjunct or replacement for aspects of psychedelic-assisted therapy for alcohol use disorder. The authors propose four clinical applications: preparing patients for psychedelics, extending their efficacy, facilitating integration after dosing, and standardizing the therapeutic set and setting. Virtual reality may also function as a placebo in clinical research and as a tool to study subjective psychedelic experiences. Integrating virtual reality into psychedelic therapy and research could enable new treatment possibilities and implementation pathways.

Autism and schizophrenia spectrum disorder: phenomenological qualitative study of patients' experience.

Frontiers in psychiatry January 1, 2025 Aleksandra Jeličić, Maja Drobnič Radobuljac, Louis Sass et al. 1 citation

People with autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) often show similar social difficulties, leading to misdiagnosis. This study used in-depth phenomenological interviews with 42 participants aged 15 to 26, all with at least average intelligence and no acute psychiatric symptoms, to compare their subjective experiences. The SSD group showed higher levels of minimal self-disorder, demarcation phenomena, paranoid anxiety, short-term memory disorder, and magical thinking. Both groups overlapped in obsessive thinking, attention problems, diminished presence in the world, social anxiety, and hyper-reflectivity. The findings suggest that a disorder of ipseity (the sense of self) is central to SSD, while a disorder of primary intersubjectivity is central to ASD.

Consciousness alterations in a cohort of young Swiss men: Associations with substance use and personality traits.

Frontiers in psychiatry January 1, 2022 Marianthi Lousiana Deligianni, Joseph Studer, Gerhard Gmel et al. 1 citation

Among 2,796 young Swiss men who had used substances, 32.2% reported at least one type of substance-induced consciousness alteration: 20.5% experienced ego dissolution, 16.7% visual pseudo-hallucinations, and 14.6% anxiety or paranoia. Former and current use of psychedelics and ketamine was linked to all three types and to a positive perceived influence on life. Associations with other substances were less consistent and not statistically significant. Sociability was negatively associated with all three alterations; anxiety-neuroticism was positively associated with ego dissolution and anxiety/paranoia; aggression-hostility with anxiety/paranoia; and sensation seeking with ego dissolution and visual pseudo-hallucinations. The findings suggest psychedelics can induce consciousness alterations perceived as beneficial, even in street-drug users.

Ketamine for negative and depressive symptoms in schizophrenia: the evidence so far.

Frontiers in psychiatry January 1, 2026 C M Diendorfer, C Bum, A Weidenauer et al.

Ketamine, a drug used for treatment-resistant depression, may offer benefits for negative and depressive symptoms in schizophrenia, though no randomized controlled trials have tested it in psychotic disorders. Negative symptoms like apathy and anhedonia are hard to treat and often overlap with depression. Case reports show ketamine can improve mood without triggering psychosis, and its dissociative effects usually fade within one to two hours. This review examines ketamine's potential advantages and risks for schizophrenia patients, focusing on negative and depressive symptoms.

Evidence in practice: implementing KAT in indigenous health services.

Frontiers in psychiatry January 1, 2026 Jean Jacque Lovely, Hiedi Yardley, Reverdi Darda et al.

A collaborative pilot program between Siksika Health Services and ATMA CENA designed and delivered a culturally responsive ketamine-assisted therapy (KAT) program within the Siksika First Nation in Alberta, Canada. Six participants (3 Indigenous, 3 non-Indigenous) completed care. Notable improvements in symptoms of depression, anxiety, and PTSD were observed, with participants reporting increased emotional regulation and stronger cultural connections. Cultural elements such as shared meals, traditional decor, and a mid-program break for cultural events were central to participant safety, trust, and meaning making. Indigenous and non-Indigenous participants treated together reported comparable gains, suggesting the model may reduce inequities in group KAT delivery. Challenges included stigma, systemic barriers, and logistical obstacles in a rural First Nation setting.

Esketamine ameliorates depression-like behavior in mice via modulation of the NRG1-ErbB4 pathway.

Frontiers in psychiatry January 1, 2026 Hang Yu, Yuqiong Zhu, Jie Wang et al.

In a mouse model of depression induced by chronic social defeat stress, susceptible mice showed reduced social interaction, lower sucrose preference, decreased NRG1 protein expression in the prefrontal cortex, and increased immobility time compared to controls. A subanesthetic dose of esketamine increased NRG1 expression in the prefrontal cortex within 30 minutes and improved social interaction and reduced immobility at both 30 minutes and 24 hours post-injection. No significant changes were observed in GAD67 or ErbB4 expression. Esketamine may rapidly improve depressive-like behavior by regulating the NRG1-ErbB4 signaling pathway.

Making sense of "senseless actions" in relation to criminal insanity.

Frontiers in psychiatry January 1, 2026 Søren Esben Rytter Heilskov, Julie Nordgaard, Unn Kristin Haukvik et al.

Delusions are often used as key evidence of psychosis in insanity assessments because they are verbalized and express faulty reality judgments. However, psychosis can also involve disturbances that are enacted rather than spoken. This paper revisits Klaus Conrad's concept of "senseless actions"—unintelligible behaviors seen in early schizophrenia—and illustrates its forensic relevance through a historical case study from Karl Wilmanns. These actions reflect a global disruption in how a person finds relevance, meaning, and constraint in the world, and may signal the transition from prodromal to manifest psychosis. The authors argue that evaluating such actions requires contextual and biographical information, and that the concept, though imperfect, can help identify reality disturbances overlooked in current forensic practice.

The therapeutic potential of ayahuasca in depression, generalized anxiety, and substance use disorders: modulation of the depressive burden in a longitudinal study.

Frontiers in psychiatry January 1, 2026 Gláucio Silva Camargos, Geraldo Magela De Faria Júnior, Marcelo Lourenço et al.

Over six months, depressive symptoms decreased significantly in 280 adults with depressive, anxiety, or substance use disorders after ritualistic ayahuasca use combined with psychotherapeutic support. Scores on the Montgomery-Åsberg Depression Rating Scale dropped shortly after the intervention and remained lower for up to 180 days, though individual responses varied. The findings suggest that ayahuasca-assisted therapy can reduce depression and anxiety and may help treat substance dependence. Variability in outcomes indicates that psychodynamic factors, including integration of the psychedelic experience and ongoing therapeutic support, are crucial for effectiveness. The work supports developing personalized psychedelic-assisted treatment protocols for complex psychiatric conditions.

NMDA receptors are not necessary for burst firing of lateral habenula neurons in mice.

Frontiers in psychiatry January 1, 2026 Rong Zhou, Jingjing Lu, Yunxiang Ling et al.

Burst firing in the lateral habenula (LHb) is linked to depression, and ketamine blocks this firing to produce rapid antidepressant effects. This study investigated whether NMDA receptors (NMDARs) are necessary for burst firing in LHb neurons. Using brain slices from adult male mice, researchers recorded spontaneous and rebound burst firing while applying NMDAR antagonists D-AP5 and MK-801. Neither antagonist altered spontaneous or rebound burst firing: the percentage of neurons showing burst firing, burst frequency, and spikes per burst remained unchanged. The results indicate that NMDARs are not required for generating burst firing in LHb neurons, though they may modulate it under certain conditions.

Case Report: Oral glutamatergic augmentation for trauma-related disorders with fluoxetine-/bupropion-potentiated dextromethorphan ± piracetam: a four-patient case series.

Frontiers in psychiatry January 1, 2026 Ngo Cheung

Four patients with hard-to-treat trauma-spectrum disorders—somatic PTSD, acute bereavement-related PTSD, trauma-linked adolescent depression, and complex PTSD with bipolar II, ADHD, and borderline features—showed clinically meaningful symptom improvement within days to weeks after starting an inexpensive oral protocol centered on dextromethorphan potentiated by fluoxetine, with optional piracetam or bupropion. Reductions in intrusive memories, rumination, somatic pain, and functional disability were noted; no episodes of dissociation, hypertension, or mania were clinically documented during follow-up, though structured screening for hypomania and serotonergic toxicity was not performed. The findings are hypothesis-generating and suggest further controlled investigation of oral NMDA-AMPA modulators for trauma-related conditions.

Mental health professionals' perspective on the use of esketamine in treatment-resistant depression and their motivation to adopt it: a Saudi cross-sectional study.

Frontiers in psychiatry January 1, 2026 Ahmad H Almadani, Ayedh H Alghamdi, Gosay M Almazyad et al.

Among 223 psychiatrists surveyed in Saudi Arabia, fewer than 20% had prescribed esketamine for treatment-resistant depression, and most of those had treated only 1-2 patients. The most frequently perceived side effects were dissociation, delusions, or hallucinations (66.82%) and dizziness or vertigo (59.19%). Older age, consultant-level practice, practice in the Western Region, lower concern about misuse, easier perceived access, and fewer concerns about the administration process were significantly linked to having prescribed esketamine. Senior registrars, registrars, and residents were less likely to prescribe than consultants. The main barriers were the administration process (66.37%) and cost (65.02%). Actual adoption remains low despite interest.

Regulation as modulation: autonomic flexibility as a physiological buffer in bipolar II disorder - a perspective on somatic regulation and mood stability.

Frontiers in psychiatry January 1, 2025 Kyndra Purcell

Bipolar II disorder involves not only mood dysregulation but also autonomic nervous system function, which shapes the depth and duration of depressive episodes. The paper introduces regulation as modulation, where autonomic flexibility acts as a physiological buffer influencing mood stability. Heart-rate variability, vagal tone, and neurovisceral integration are key biomarkers linking emotional resilience and physiological coherence. When these systems are compromised, recovery from depressive episodes slows; when strengthened through breathwork, interoception, grounding, and somatic awareness, recovery accelerates. The argument integrates existing studies and longitudinal self-monitoring data, noting consistent patterns between autonomic dysregulation and bipolar lows. Somatic regulation should be regarded as a core therapeutic pathway alongside medication and psychotherapy.