European Psychiatry
April 1, 2024
K. Sattler, T. Walia, V. Tsang
A crossover trial of 32 participants undergoing ketamine-assisted group therapy for treatment-resistant mental health conditions compares two types of music—a "weightless" playlist and a "grounding" playlist—administered in counterbalanced order. The study evaluates subjective clinical efficacy via psychiatric questionnaires (PHQ-9, GAD-7, PCL-5) and objective changes in brain activity measured by EEG from a MUSE headband before and after each session. Order effects and relevant demographic and medical factors will be controlled. No prior work has examined how different music types influence patient experience with ketamine-assisted therapy in a group setting.
European Psychiatry
November 17, 2023
L. Tjokrodipo, A. Sneep, P. Michielsen
The incubus phenomenon is a sleep-related disorder combining sleep paralysis with compound hallucinations, including sensed presence, fear, visual and auditory hallucinations, unusual body experiences, chest pressure, breathing difficulty, and pain. A 29-year-old man with intellectual disability, psychotic disorder, and cannabis use disorder was diagnosed with narcolepsy and cataplexy; his hallucinations included sexual themes, breathing difficulty, moving sensations, and chest pressure. Literature review indicates a lifetime prevalence of 0.11% in the general population versus 0.41% in psychiatric patients, suggesting the phenomenon is four times more common in those with psychiatric history and should not be mistaken for psychotic disorder. Recognizing it is important for proper treatment with anxiolytics, antidepressants, anticholinergics, or anti-epileptics, along with sleep hygiene.
European Psychiatry
November 17, 2023
V. Tomacsek, B. Blaskovich, R. Reichardt et al.
People with nightmare disorder show faster heart rates during sleep, particularly before and during REM sleep, compared to healthy controls, but their heart rate variability is not lower. During an emotional picture-rating task while awake, they also show different heart rate and variability patterns, suggesting altered emotion regulation. Their subjective ratings of the pictures did not differ from controls. The findings point to both stable autonomic changes during sleep and situation-dependent responses to emotional stimuli in nightmare disorder.
European Psychiatry
November 17, 2023
C. Alvarez Garcia, L. Nocete Navarro, A. Sanz Giancola
Posttraumatic nightmares (PTN) are a frequent symptom of posttraumatic stress disorder, with prevalence up to 96%, and are an independent risk factor for suicide. The two main current treatments are Imagery Rehearsal Therapy (IRT), a cognitive-behavioral intervention that helps patients change nightmare content, and prazosin, an alpha-adrenergic receptor antagonist. However, prazosin has not shown significant differences compared to placebo. Emerging evidence suggests nabilone, a synthetic cannabinoid, may be helpful; a Canadian clinical trial found that 72% of patients experienced complete disappearance or important reduction of PTN. More research is needed for an effective treatment.
European Psychiatry
November 17, 2023
K. Böge, I.M. Hahne, N. Bergmann et al.
A four-week mindfulness-based group therapy added to treatment-as-usual is feasible and acceptable for in-patients with schizophrenia spectrum disorders, with 95% protocol adherence and 95% retention. Compared to treatment-as-usual alone, the combined therapy produced significant improvements in mindfulness and negative symptoms, with medium-to-large effects on mindfulness, positive and negative symptoms, depression, psychological flexibility, quality of life, and social functioning. No serious adverse effects occurred. The findings suggest a proof of concept for mindfulness-based interventions in this population and warrant a larger trial.
European Psychiatry
November 17, 2023
G. Simões, S. Jesús, R. Silva
Perception transforms raw sensory stimuli into meaningful information at the cortical level, while imagery is an internal mental representation actively drawn from memory. Although often distinguished by their differential features, many characteristics are shared rather than unique. The authors analyze the similarities and differences between imagery and perception at the phenomenological level and examine their roles in psychopathological alterations such as hallucinations, pseudohallucinations, pareidolic illusions, abnormal imagery, sensory deprivation, and dreams. Understanding imagery and its formal characteristics is necessary for better recognizing the nature of perceptions and related psychopathological alterations, as well as the mechanisms uniting these concepts.
European Psychiatry
November 17, 2023
N. Báthori, B. Polner, P. Simor
A network analysis of 1,419 general-population adults (77% female) mapped connections among specific insomnia symptoms, dreaming features, and schizotypy dimensions. Disorganization, frequent awakenings, and nightmares were the most central nodes within their respective clusters. Frequent nightmares acted as a bridge, linking unusual perceptual experiences with frequent awakenings. The results suggest that particular sleep complaints and specific schizotypy dimensions are differentially connected, highlighting heterogeneity often masked by umbrella terms like insomnia and psychosis.
European Psychiatry
October 23, 2023
M. Bogenschutz
The field of psychedelic medicine has advanced rapidly in the last 2-3 years, with a notable increase in the number and size of controlled clinical trials, more sophisticated conceptual models for understanding therapeutic effects, and progress toward treatment models that could enable access to safe and effective psychedelic therapies if regulatory approval is granted. Despite these advances, the field remains in its infancy, and much more work is needed to determine the contributions of psychedelics to healthcare and neuroscience.
European Psychiatry
October 23, 2023
A. U. Parnas
Auditory verbal hallucinations (AVH) in schizophrenia are not clear-cut perceptual errors but are often preceded by subtle anomalies of subjective experience, such as feeling different or thought interference. In a qualitative study of 20 readmitted patients with paranoid schizophrenia, many could not tell whether voices were internal or external and doubted whether they were voices or just thoughts. The label 'voices' was typically acquired in psychiatric settings. AVH alone do not indicate mental disturbance unless part of a deeper change in consciousness. There is continuity between thinking and hallucinating; AVH occur in the patient's intimate sphere, not in shared social space. Psychiatrists' insistence on framing AVH as perceptions may obscure their true nature.
European Psychiatry
October 23, 2023
C. Mariem, M. Gros
Mindfulness therapy, particularly Dialectical behavior therapy (DBT), is a main component for treating borderline personality disorder (BPD). The therapy teaches skills for controlling intense emotions and reducing self-destructive behaviors. Decentering appears to play a crucial role as a primary mechanism of action. The evidence, assessed through a systematic review of PubMed/Medline, suggests that mindfulness-based approaches are effective for BPD, though medical treatment alone is insufficient.
European Psychiatry
March 1, 2023
S. Kamrun, T. Sultana, F. Faruki et al.
Synthetic cannabinoids (SCs), known as K2 or spice, are more potent than THC and can cause severe health effects. A review of case series and cross-sectional studies found that SC intoxication leads to life-threatening physical and psychiatric symptoms. In 30 ICU patients, common outcomes included agitation (33%), coma (33%), seizure (20%), acute respiratory failure (60%), tracheal intubation (70%), rhabdomyolysis (26%), invasive mechanical ventilation (40%), acute kidney injury (26%), and cardiotoxic effects. Among 50 male cases, altered perception (68%), palpitation (76%), chest pain (12%), and convulsion were reported. Psychiatric presentations include acute anxiety, agitation, psychosis, paranoia, disorientation, hallucinations, and delusions. Clinicians should be vigilant for these varied manifestations.
European Psychiatry
June 1, 2022
B. Leal, D. Vila-Chã, S. Garcia et al.
Nitrous oxide, commonly known as laughing gas, shows promise as a treatment for treatment-resistant major depression. At least two randomized clinical trials since 2018 have demonstrated that a single one-hour inhalation of nitrous oxide produces considerable antidepressant effects that last at least two weeks. A more recent study comparing 25% and 50% concentrations found that the lower dose offers similar efficacy with fewer adverse effects. While these results are encouraging, further research is needed, including comparisons with other established treatments for treatment-resistant depression.
European Psychiatry
June 1, 2022
J. Bramness
Cannabis use, particularly high-potency products with increased THC content, is linked to a rise in cannabis-induced psychosis and schizophrenia. In Scandinavian countries, the incidence of cannabis-induced psychosis and the population-attributable fraction of cannabis for schizophrenia have increased alongside treatment seeking for cannabis use disorders. Up to one third of people with cannabis-induced psychosis later receive a schizophrenia diagnosis, strengthening evidence for a causal relationship. The authors argue that cannabis-induced psychosis should be reclassified from the substance-use chapter (F1) to the psychotic-disorders chapter (F2) of the ICD-10, as no other psychotic diagnosis specifies a precipitating factor.
European Psychiatry
June 1, 2022
C. Laranjeira, A. Querido
A cross-sectional survey of 23 adults with chronic pain found that most had never tried mindfulness but knew what it was and considered it a viable option for pain self-management. The sample was mostly middle-aged women with fibromyalgia; nearly half had experienced pain for over 20 years. Average pain intensity was moderate, acceptance was low, and pain interfered with daily activities. Moderate positive correlations emerged between pain acceptance and willingness to practice mindfulness, and between satisfaction with mindfulness practice and pain self-control. The authors argue that non-pharmacological measures such as mindfulness should be included in chronic pain management.
European Psychiatry
April 1, 2021
P. Holas
A 4-week internet-delivered mindfulness-based cognitive therapy (i-MBCT) reduced symptoms of COVID-19-related adjustment disorder more than progressive muscle relaxation or a waiting list. Among 438 adults diagnosed with adjustment disorder who were randomly assigned to i-MBCT, i-PMR, or a waiting list, only i-MBCT produced a significant drop in adjustment disorder symptoms. Both i-MBCT and i-PMR lessened depression and anxiety, but i-MBCT yielded the largest improvements. The authors describe these results as preliminary and call for further research.
European Psychiatry
April 1, 2021
M. Trigo
A review of recent literature on psychedelic drugs such as LSD for depression finds that data from clinical research show LSD relieves distress concerning death, particularly in terminally ill cancer patients, and helps treat addictions including alcoholism and nicotine. There is more limited data on classic hallucinogens for depression and anxiety disorders. The studies completed to date are not sufficient to establish clinically relevant effects, though outcomes are encouraging and larger, well-designed, placebo-controlled trials are underway or being planned.
European Psychiatry
April 1, 2017
A. Oda
Cannabis psychosis and methamphetamine psychosis differ in their core symptoms: methamphetamine psychosis typically involves auditory hallucinations and paranoia that resolve quickly with treatment, whereas cannabis psychosis is characterized by megalomania and a pseudo-enlightenment experience of supernatural existence, leading users to cling to an unrealistic sense of omnipotence and repeat abuse. Because cannabis grows wild and is legal in some countries, users often lack guilt and instead enjoy contact with supernatural power, resulting in social withdrawal and contributing to social problems. The authors argue psychiatrists should recognize these risks and the difficulty of rehabilitating cannabis users.
European Psychiatry
April 1, 2017
M. Preve, S. Casigliani, L. Tognola et al.
NBOMe compounds, a new group of toxic phenethylamine derivatives used recreationally, pose larger risks than other hallucinogens due to limited knowledge, low price, and internet availability. This review of clinical evidence and a case report of 25C-NBOMe use found effects including hallucinations, violent agitation, rhabdomyolysis, and kidney injury. The clinical features were similar to those of other NBOMe analogues (25I-NBOMe, 25B-NBOMe). The authors call for further quantitative studies with large samples and longer follow-up to confirm these observations.
European Psychiatry
March 1, 2016
I. Ezquiaga, M. Grifell, L. Galindo et al.
Between 2009 and 2015, 56 samples of the potent hallucinogen 25I-NBOMe were identified among 21,198 drug samples submitted to a Spanish harm-reduction service. Most samples (42.8%) were sold as LSD, while only 21.4% were sold as 25I-NBOMe itself; others were misrepresented as related substances or even gummy bears. All 25I-NBOMe samples appeared after 2012, with a peak in 2013. The substance has high affinity for serotonin 5HT2a receptors and has been linked to toxicity. The authors call for more research and for physicians to be aware of novel psychoactive substances and their clinical differences.
European Psychiatry
March 1, 2016
I. Hamilton, P. Galdas, H. Essex
Male cannabis users outnumber female users by 2:1, and a similar ratio appears for hospital admissions with schizophrenia or psychosis. However, the ratio increases to 4:1 for admissions with cannabis psychosis, indicating marked gender differences. The research used British Crime Survey data, Hospital Episode Statistics, and prior epidemiological studies. Attending to gender is important for understanding and providing gender-sensitive services.
European Psychiatry
November 1, 2015
L. Sala, C. Vindreau, S. Sweerts et al.
Mindfulness-based programs adapted from MBSR and MBCT, which focus on self-regulation and acceptance of unpleasant emotions and sensations, offer a promising approach for eating disorders where control and avoidance are prominent. These programs target obsessive aspects (e.g., rumination) and compulsive aspects (e.g., loss-of-control eating) associated with these disorders. At the CMME, Sainte-Anne Hospital, an eight-session 'MBCT Bulimia' protocol was developed, modifying cognitive tools and meditation duration for patients with eating disorders. The study involved twenty-four subjects from the day hospital and aimed to evaluate the program's impact on bulimia and binge eating disorder. Preliminary results are presented, along with plans for further clinical research.
European Psychiatry
November 1, 2013
L. Sala, D. Rambaud, B. Aubriot
A pilot study adapted Mindfulness-Based Cognitive Therapy (MBCT) for social phobia. Of 30 enrolled patients, 24 completed the 8-week protocol; 6 were not retested. The authors describe the rationale for adapting Segal et al.'s MBCT protocol, originally designed for depression relapse prevention, to social phobia, noting few existing studies and none in a French population. They detail group formats, patient profiles, and assessment tool outcomes, discussing results, limitations, and future directions.
European Psychiatry
March 1, 2011
P. Milz, A. Theodoropoulou, S. Tei et al.
Across five different meditation traditions (Tibetan Buddhist, Qigong, Sahaja Yoga, Ananda Marga Yoga, and Zen), experienced meditators showed common changes in brain electrical activity when moving from resting to meditation. Compared to resting, meditation produced a significant decrease in alpha-2 brainwave power (10.5–12 Hz) and significant increases in beta-3 (21.5–30 Hz) and gamma (35–44 Hz) power. Theta band power (6.5–8 Hz) also increased but this change was not statistically significant. These shared patterns suggest that despite differing techniques, meditation traditions may engage common neural processes.
European Psychiatry
March 1, 2011
H. Murphy, M. Lahtinen
Mindfulness-based cognitive therapy (MBCT) is a group treatment that combines meditation with cognitive therapy to reduce the risk of recurrent depression. Little is known about how patients experience the meditative homework assignments in a UK public health setting. Six in-depth interviews were analyzed using Interpretative Phenomenological Analysis. The results focus on factors that helped or hindered participants in completing meditative homework, and how the practice transformed participants' sense of self and social relatedness. The findings are discussed in relation to existing psychological literature and the practice of MBCT, with implications for clinical practice in preventing recurrent depression.
European Psychiatry
March 1, 2011
P.L. Faber, D. Lehmann, P. Milz et al.
During meditation, the brain shows more independent processes than during ordinary rest. EEG recordings from experienced meditators in five traditions (Tibetan Buddhist, Qigong, Shaja Yoga, Ananda Marga Yoga, and Zen) were analyzed using Omega Complexity, a measure of how many independent processes generate the brain's electrical activity. Omega Complexity was higher during meditation than during resting in all five groups, with statistically significant increases for Tibetan Buddhists, Ananda Marga Yoga, and Zen. The subjectively pleasant feelings during meditation appear to accompany a brain state with more independent processes, not fewer.