A 60-year-old man with recurrent depression and a history of delusions died after psilocybin-assisted therapy. Psilocybin-triggered delusions and emotional dysregulation may have contributed to the death. A weak therapeutic alliance hindered assessment of the patient's internal state. Delusional symptoms may contraindicate psychedelic interventions. The case emphasizes the need for thorough assessment and close follow-up in complex cases.
An adapted version of mindfulness-based cognitive therapy (MBCT) with nine instead of eight weekly sessions and reduced exercise duration was tested in a psychiatric sample. Of 120 participants, 35% left before the advanced stage and 50.8% completed the program. Neither baseline depression, mindfulness, nor sociodemographic variables predicted completion. The number of sessions attended in the introductory phase was the only significant predictor in a multiple logistic regression. Prior group therapy experience strongly predicted attendance of the first three sessions, and therapist ratings of motivation and predicted dropout also related to attrition. The modified MBCT proved feasible for stabilizing later-session attendance.