Journal of Clinical Medicine - The Consciousness Library

Psilocybin-Assisted Therapy in Psychiatry: A Narrative Clinical Review of Mechanisms, Therapeutic Applications, and Emerging Evidence (2025–2026)

Journal of Clinical Medicine August 12, 2026 Teodora Anghel, Adriana Cojocaru, Lavinia Hogea et al.

Background/Objectives: Psilocybin-assisted therapy has progressed from early proof-of-concept work to a substantially expanded evidence base, with four pivotal studies published in 2025–2026 that were not incorporated into earlier reviews. This review synthesizes the pharmacological and neurobiological foundations of psilocybin and appraises clinical evidence across major depressive disorder...

DOI: 10.3390/jcm15166228

Impact of Mindfulness-Based Cognitive Therapy on Trajectory of Mood States in Patients with Chronic Pain: A Retrospective Observational Study of Within-Session Evaluations

Journal of Clinical Medicine February 28, 2026 Chisato Tanaka, Yuta Shinohara, Saki Takaoka et al.

Background/Objectives: Mindfulness-Based Cognitive Therapy (MBCT) is a well-documented treatment option for chronic pain. However, few studies have examined the emotional state experienced by participants with chronic pain during the sessions. This study aimed to assess the trajectory of mood experiences in an MBCT program and evaluate the effect on temporal mood state. Methods: The Temporary...

DOI: 10.3390/jcm15051839 Mood Confusion Observational study Cognition +6

Integrating Psychiatric, Psychotherapeutic, and Nursing Care in Intranasal Esketamine for Treatment-Resistant Depression

Journal of Clinical Medicine February 20, 2026 Vassilis Martiadis, Fabiola Raffone, Serena Testa et al. 7 citations

Background/Objectives: Intranasal esketamine has emerged as an effective treatment for patients with treatment-resistant depression (TRD), providing rapid symptom relief when conventional antidepressant strategies fail. While its pharmacological efficacy has been demonstrated in randomized controlled trials, less attention has been paid to the organizational, relational, and multidisciplinary...

DOI: 10.3390/jcm15041629 Major depressive disorder Treatment-resistant depression Anhedonia Multidisciplinary approach +10

Efficacy and Safety of Psychedelics in Mental Disorder Cases: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials

Journal of Clinical Medicine December 29, 2025 Monika Dominiak, Adam Gędek, Szymon Modrzejewski et al. 2 citations

Background: Psychedelic-assisted therapy is gaining renewed attention as a potential treatment for various mental disorders. Despite increasing numbers of randomized controlled trials (RCTs) and meta-analyses, a comprehensive synthesis of the evidence across different substances and indications is lacking. This umbrella review aims to evaluate the effectiveness and safety of...

DOI: 10.3390/jcm15010253 MDMA Psilocybin Major depressive disorder Alcohol use disorder +8

Effectiveness of Intranasal Esketamine on Suicidal Ideation and Depressive Symptoms in Patients with Treatment-Resistant Depression: A Longitudinal Study

Journal of Clinical Medicine December 29, 2025 Matteo Leonardi, Alice Frediani, Mauro Angeletti et al.

Background: Suicidal ideation (SI) represents a clinical challenge in patients with treatment-resistant depression (TRD), and the management of this condition should be as rapid and effective as possible. Intranasal Esketamine has shown promise in patients with TRD due to its rapid onset of action on both SI and depressive symptoms. Since this medication has been recently approved, real-world...

DOI: 10.3390/jcm15010250 Treatment-resistant depression Major depressive disorder Suicidal ideation Depression economics +7

Patients’ Voices on Ketamine for Treatment-Resistant Depression: A Narrative Review of Qualitative Perspectives

Journal of Clinical Medicine December 25, 2025 Michał Walaszek, Wiesław Jerzy Cubała, Zofia Kachlik 1 citation

Treatment-resistant depression (TRD) remains a significant public-health challenge, with many patients failing to respond to conventional therapies. Ketamine has emerged as a rapid-acting intervention, but quantitative outcomes alone do not capture patients' lived experiences, which shape engagement, acceptability, and adherence. We conducted a narrative review of qualitative and mixed-methods...

DOI: 10.3390/jcm15010150 Ketamine Thematic analysis Qualitative research Narrative review +6

Mindfulness-Based Stress Reduction Program to Improve Well-Being and Health in Healthcare Professionals.

Journal of Clinical Medicine October 28, 2025 Marco Marotta, Niccolo Grassi, Alessandro Pingitore et al.

Aim: To evaluate basal well-being and the effects of a Mindfulness-Based Stress Reduction (MBSR) program in health-care professionals (HCPs), a recognized worker category subjected to elevated stress from job conditions. Methods: A quasi-experimental pre-post study was conducted in Italian HCPs. Well-being (assessed by Psychological General Well-Being Index-PGWBI), stress (Perceived Stress...

DOI: 10.3390/jcm14217655 Full text Mindfulness Mbi Pgwbi Pss +8

Dysfunction in Cardiovascular Autonomic Modulation Caused by Chronic Use of Ketamine Hydrochloride Can Be Prevented by Aerobic Exercise Training in Wistar Rats.

Journal of Clinical Medicine October 24, 2025 Adriano Dos-Santos, Lucas Porto Fernandes Dos Santos, Gabriela Da Silva-Santos et al.

Background/Objectives: Ketamine, widely used for its anesthetic and analgesic properties, has been linked to cardiotoxic effects, particularly with chronic use. Prolonged ketamine exposure may impair cardiovascular function, while aerobic exercise is known to promote protective cardiovascular adaptations. This study aimed to evaluate whether aerobic training can mitigate the deleterious...

DOI: 10.3390/jcm14217548 Full text Cardiovascular autonomic control Ketamine: ketamine Chronic ketamine exposure Long-term ketamine-related issues +8

Evolution and Comparative Analysis of Clinical Trials on Psilocybin in the Treatment of Psychopathologies: Trends in the EU and the US

Journal of Clinical Medicine September 19, 2025 Ana Flavia Burlec, Cornelia Mircea, Irina Macovei et al.

Background/Objectives: This study examines the development of clinical trials investigating psilocybin for the treatment of psychopathologies, with a comparative focus on the United States (US) and the European Union (EU). The objective is to identify regional differences in trial progression, research infrastructure, and regulatory frameworks. Methods: A mixed-methods approach was applied,...

DOI: 10.3390/jcm14186613

Sex and Age Differences in Ketamine Efficacy and Safety in Chronic Pain Alleviation.

Journal of Clinical Medicine June 16, 2025 Gisèle Pickering, Marion Voute, Marc Sorel et al. 2 citations

Background: Ketamine use for chronic pain and depression has increased worldwide, but sex differences in its efficacy and safety have been little studied; this study examines existing evidence to address this gap. Methods: A prospective, multicenter, one-year observational study in 585 chronic pain patients was performed; 256 patients had one administration of ketamine and 329 had two or more....

DOI: 10.3390/jcm14124269 Full text Refractory pain Sex Ketamine therapy Chronic pain management +2

Decreasing Preoperative Anxiety in Patients with Newly Available Multimodal Approaches-A Narrative Review.

Journal of Clinical Medicine April 24, 2025 Weronika Kisielewska, Michał Kościółek, Weronika Kowalczyk et al. 16 citations

Preoperative anxiety affects approximately 80% of adult patients; thus, identifying patients with excessive anxiety and implementing appropriate interventions can significantly reduce the risk of deterioration during the perioperative period. This narrative review presents current knowledge about pharmacological and nonpharmacological methods for reducing preoperative anxiety. Commonly used...

DOI: 10.3390/jcm14092940 Full text Anti-anxiety agents Informed consent Perioperative care Psychotherapy +6

Psychedelics and Suicide-Related Outcomes: A Systematic Review

Journal of Clinical Medicine February 20, 2025 Shakila Meshkat, Taha Malik, Jennifer Swainson et al. 3 citations

Background/Objectives: Suicide accounts for 1.4% of global deaths, and the slow-acting nature of traditional treatments for suicide risk underscores the need for alternatives. Psychedelic therapies may rapidly reduce suicide risk. This systematic review evaluates impact of psychedelic therapies on suicide-related outcomes. Methods: A systematic search of MEDLINE, Embase, PsycINFO, and...

DOI: 10.3390/jcm14051416 MDMA Psilocybin Suicidal ideation Odds ratio +7

Randomized Trial: A Pilot Study Investigating the Effects of Transcendental Meditation and Yoga Through Retinal Microcirculation in Cardiac Rehabilitation.

Journal of Clinical Medicine January 3, 2025 Adam Saloň, Karin Schmid-Zalaudek, Bianca Steuber et al. 2 citations

Background/Objectives: Cardiovascular diseases are a leading cause of death, and psychosocial stress is considered a contributing factor to these issues. With the rising number of heart surgeries, proper rehabilitation post-surgery is essential. Previous studies have demonstrated the positive impact of yoga and transcendental meditation on the cardiovascular system. This pilot study aimed to...

DOI: 10.3390/jcm14010232 Full text Meditation Cardiac rehabilitation Exercise therapy Retinal imaging +1

Treatment Advances in Perinatal Depression: Innovations and Promising Approaches.

Journal of Clinical Medicine December 18, 2024 Kathleen Kendall-Tackett 2 citations

Background/Objectives: Psychotherapy and antidepressants are the standard treatment for depression during pregnancy or postpartum. However, several new treatments for depression represent major advances and paradigm changes. This commentary highlights some innovative treatment options that are on the horizon. Most of these modalities are promising, and most are non-invasive. Many of these...

DOI: 10.3390/jcm13247744 Full text Esketamine Acupuncture Brexaonolone Infant massage +7

Psychotic Arousal and the Psychopathology of Acute Schizophrenia: An Exploratory Study of the Experiential Emotional State in Acute Psychosis

Journal of Clinical Medicine September 15, 2024 Maria Margariti, Ilias I. Vlachos, Dimitra Mpourazana et al. 4 citations

Background: Increasing research data suggest that the dysfunction of emotional brain systems may be an important contributor to the pathophysiology of schizophrenia. However, contemporary psychopathology consistently underestimates the role of emotions in the phenomenology of the disease. Psychotic arousal (PA) is a conceptually defined psychopathological construct aiming to portray the...

DOI: 10.3390/jcm13185477 Anxiety Psychopathology Clinical psychology Cronbach's alpha +5

Heart Rate Variability as a Potential Predictor of Response to Intranasal Esketamine in Patients with Treatment-Resistant Depression: A Preliminary Report.

Journal of Clinical Medicine August 14, 2024 Lorenzo Moccia, Giovanni Bartolucci, Maria Pepe et al. 7 citations

Background: Esketamine has received approval as a nasal spray (ESK-NS) for treatment-resistant depression (TRD) and evidence from real-world investigations has confirmed the effectiveness of ESK-NS, albeit with interindividual differences in response. Heart rate variability (HRV), defined as the fluctuation in time interval between consecutive heartbeats, can be used to measure autonomic...

DOI: 10.3390/jcm13164767 Full text Esketamine Mood disorders Personalized medicine Mental-health +4

10-Week Trajectories of Candidate Psychological Processes Differentially Predict Mental Health Gains from Online Dyadic versus Mindfulness Interventions: A Randomized Clinical Trial.

Journal of Clinical Medicine June 3, 2024 Malvika Godara, Tania Singer 5 citations

Background: App-based contemplative interventions, such as mindfulness-based interventions, have gained popularity for the promotion of mental health; however, the understanding of underlying intervention-specific mechanisms remains limited, especially related to novel inter-relational dyadic practices. Methods: We tested (n = 253) seven putative mechanisms underlying two brief (daily 12-min)...

DOI: 10.3390/jcm13113295 Full text Anxiety Depression Mindfulness Acceptance +4

Mitochondrial Metabolism in Major Depressive Disorder: From Early Diagnosis to Emerging Treatment Options.

Journal of Clinical Medicine March 17, 2024 Ane Larrea, Laura C Sánchez-sánchez, Eguzkiñe Diez-Martin et al. 21 citations

Major Depressive Disorder (MDD) is one of the most disabling diseases in the world. MDD is traditionally diagnosed based on a patient's symptoms, which can lead to misdiagnosis. Although the pathogenic mechanisms of MDD are unknown, several studies have identified mitochondrial dysfunction as a central factor in the onset and progression of MDD. In the context of MDD, alterations in...

DOI: 10.3390/jcm13061727 Full text Major depressive disorder Mdd Inflammation Ketamine/esketamine +8

Intensity of Psychoactive Substance Use Affects the Occurrence of Prodromal Symptoms of Psychosis.

Journal of Clinical Medicine January 28, 2024 Gniewko Więckiewicz, Iga Florczyk, Maciej Stokłosa et al. 1 citation

Psychosis is defined as a series of symptoms that impair the mind and lead to a kind of loss of reference to reality. Development of psychosis is usually preceded by the appearance of prodromal symptoms. Numerous attempts have been made to find out how psychoactive substances can influence the onset and development of psychotic disorders, but to date there are no studies that show a link...

DOI: 10.3390/jcm13030760 Full text Drug addiction Dudit Pq-b Drugs +7

Evaluation of a Modified Mindfulness-Based Stress Reduction Intervention for Adults with Cerebral Palsy and Anxiety and/or Emotion Regulation Difficulties-A Randomised Control Trial.

Journal of Clinical Medicine December 19, 2023 Hayley Smithers-Sheedy, Emma Waight, Katherine L Swinburn et al. 4 citations

Mindfulness-Based Stress Reduction (MBSR) has not yet been evaluated for people with cerebral palsy (CP). The aims of this randomised control trial were to investigate whether a modified telehealth MBSR program could improve mindfulness and reduce depression, anxiety, and emotion regulation difficulties among adults with CP with elevated anxiety and/or emotional regulation difficulties....

DOI: 10.3390/jcm13010001 Full text Anxiety Cerebral palsy Emotion regulation Mindfulness-based stress reduction

Awake or Sleeping? Maybe Both… A Review of Sleep-Related Dissociative States.

Journal of Clinical Medicine June 6, 2023 Maria Eduarda Sodré, Isabel Wießner, Muna Irfan et al. 15 citations

Recent studies have begun to understand sleep not only as a whole-brain process but also as a complex local phenomenon controlled by specific neurotransmitters that act in different neural networks, which is called "local sleep". Moreover, the basic states of human consciousness-wakefulness, sleep onset (N1), light sleep (N2), deep sleep (N3), and rapid eye movement (REM) sleep-can concurrently...

DOI: 10.3390/jcm12123876 Full text Lucid dreaming Anesthesia Daydreaming Dissociative states +6

How Does Meditation-Based Lifestyle Modification Affect Pain Intensity, Pain Self-Efficacy, and Quality of Life in Chronic Pain Patients? An Experimental Single-Case Study.

Journal of Clinical Medicine May 31, 2023 Karin Matko, Meike Burzynski, Maximilian Pilhatsch et al. 5 citations

Chronic pain is a growing worldwide health problem and complementary and integrative therapy options are becoming increasingly important. Multi-component yoga interventions represent such an integrative therapy approach with a promising body of evidence. The present study employed an experimental single-case multiple-baseline design. It investigated the effects of an 8-week yoga-based mind-body...

DOI: 10.3390/jcm12113778 Full text Meditation Chronic pain Ethics Individual differences +6

Sleep Paralysis and Lucid Dreaming-Between Waking and Dreaming: A Review about Two Extraordinary States.

Journal of Clinical Medicine May 12, 2023 Severin Ableidinger, Brigitte Holzinger 13 citations

Sleep paralysis and lucid dreams are two states of consciousness that are connected to REM sleep but are defined by higher awareness in contrast to regular REM sleep. Despite these similarities, the two states differ widely in their emotional tone and their perceived controllability. This review aims to summarize the current research containing sleep paralysis and lucid dreams. However, given...

DOI: 10.3390/jcm12103437 Full text Rem sleep Lucid dreams Sleep paralysis

App-Based Mindfulness Meditation Training and an Audiobook Intervention Reduce Symptom Severity but Do Not Modify Backward Inhibition in Adolescent Obsessive-Compulsive Disorder: Evidence from an EEG Study

Journal of Clinical Medicine March 24, 2023 Sarah Rempel, Lea L. Backhausen, Maria McDonald et al.

(1) Background: 1–2% of children and adolescents are affected by Obsessive-Compulsive Disorder (OCD). The rigid, repetitive features of OCD and an assumed disability to inhibit recent mental representations are assumed to have led to a paradoxical advantage in that the Backward Inhibition (BI) effect was recently found to be lower in adolescents with OCD as compared to healthy controls. It was...

DOI: 10.3390/jcm12072486 Full text

Lapses of the Heart: Frequency and Subjective Salience of Impressions Reported by Patients after Cardiac Arrest.

Journal of Clinical Medicine March 2, 2023 Fritz Sterz, Michael L Berger, Gerhard Ruzicka et al.

After cardiac arrest (CA), some patients report impressions with highly realistic features, often referred to as near-death experience (NDE). The frequency of such episodes seems to be variable, with various types of content. In a prospective study, we subjected 126 CA cases treated at the Department of Emergency Medicine of the Medical University of Vienna under carefully controlled conditions...

DOI: 10.3390/jcm12051968 Full text Cardiac arrest Cardiopulmonary resuscitation Meeting deceased relatives Structured interview +2

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