Background: Comorbidity of bipolar disorder and aspects of neurodevelopmental disorders present unique challenges and opportunities in understanding the formation and maintenance of selfhood and worldview in psychopathology. Traditional cognitive models often overlook the narrative and phenomenological dimensions of patient experience, particularly how autobiographical narration and emotionally...
Rapid-acting antidepressants show that mood can lift within hours when glutamatergic circuits shift from an "NMDA-dominant" to an "AMPA-dominant" state. Intravenous ketamine achieves this flip but is hampered by dissociation and logistics, while dextromethorphan + bupropion (Auvelity®) primarily supplies the initial NMDA blockade and yields slower, less durable benefit. We hypothesize that a...
Treatment-resistant depression (TRD) is often accompanied by persistent suicidal ideation and poor response to conventional antidepressants. Intranasal esketamine, a non-selective NMDA receptor antagonist, provides rapid antidepressant and anti-suicidal effects; transient dissociation is common, whereas ataxia-like "drunken gait" is rarely described. A 19-year-old woman with recurrent...
Obsessive-Compulsive Disorder (OCD) can present significant challenges to individuals mental health, characterized by intrusive thoughts and repetitive maladaptive behaviors. Recent research into alternative treatments has highlighted psychedelics, notably psilocybin, for their potential therapeutic benefits in various psychiatric disorders, including OCD. This case study evaluated the impact...
Ketamine-Assisted Therapy (KAT) presents a promising alternative for addressing mental health challenges, particularly in treatment-resistant conditions, yet little exists in the literature guiding its implementation in an Indigenous context, for Indigenous participants, or describing culturally adapted delivery models. This paper presents insights and lessons learned from a collaborative pilot...
Esketamine is an innovative treatment for individuals with treatment-resistant depression (TRD). However, its adoption could depend on the perceptions and motivations of prescribing psychiatrists, among other factors. This study aims to explore the attitudes of psychiatrists (of all levels, including those in training) across Saudi Arabia toward the use of esketamine for TRD and investigate the...
Burst firing in the lateral habenula (LHb) is enhanced under stress and depression, and ketamine blocks burst firing in LHb to exert a rapid antidepressant effect. Thus, burst firing in LHb may serve as a cellular mechanism of depression and a promising therapeutic target for developing novel antidepressants. However, the mechanisms underlying burst firing in LHb are not fully understood. The...
In the assessment of criminal insanity, delusions play a particularly important role, because they express reality judgments, which, due to their verbalized form, serve well as "evidence" of psychosis. However, psychosis, understood as a fundamentally impaired sense of reality, can also involve disturbances that are neither verbalized nor inferential, but mainly enacted. In this paper, we...
Schizophrenia (SCZ) is a severe psychiatric condition characterized by positive symptoms such as hallucinations or delusions, as well as negative symptoms such as apathy, anhedonia and avolition. Given their chronic nature and limited response to current treatments, managing negative symptoms is a significant challenge for healthcare providers. Furthermore, many individuals with SCZ suffer from...
Traditional monoaminergic medications often offer limited relief for the physical and cognitive symptoms of post-traumatic stress disorder (PTSD) and complex PTSD. Growing data now point to fast-acting, glutamate-based treatments that boost synaptic plasticity and interrupt fear-conditioned neural circuits. We report four sequential cases of hard-to-treat trauma-spectrum disorders-somatic PTSD,...
Esketamine has a significant and rapid antidepressant effect. Although studies have shown that Neuregulin 1 (NRG1) and it's signaling pathway are associated with depression, the possible regulatory relationship of esketamine on the NRG1-ErbB4 pathway is not yet clear. To induce depressive-like behavior in mice, a Chronic Social Defeat Stress (CSDS) model was established. Behavioral indicators...
Frontiers in Psychiatry2026Gláucio Silva Camargos, Geraldo Magela De Faria Júnior, Marcelo Lourenço et al.
This longitudinal observational study evaluated changes in depressive symptoms associated with ritualistic ayahuasca use in patients diagnosed with depressive disorders, as well as depressive burden in individuals with anxiety and substance use disorders. The research was conducted with 280 adults treated at clinics in the northwestern region of the state of São Paulo, under the jurisdiction of...
Frontiers in Psychiatry2026S Mudasser Shah, Muhammad Jahangir, Ghada Saleh Alhudaithi et al.
The fascia, a pervasive connective tissue network, has traditionally been studied for its structural and biomechanical roles in the human body. However, emerging evidence suggests that fascia may also play a significant role in the pathophysiology of psychiatric disorders. This review article explores the potential links between fascial dysfunction and mental health conditions such as...
The Assessment of Clinician's Subjective Experience (ACSE) is a self-report questionnaire developed to evaluate clinicians' subjective experiences during patient interactions. While its psychometric properties and clinical validity have been supported, its neurobiological correlates have not yet been investigated. In this pilot study, two clinicians and ten patients participated in a...
Treatment-resistant depression (TRD) poses a significant challenge, with many patients failing to achieve remission with conventional therapies. While repetitive Transcranial Magnetic Stimulation (rTMS) is an established and effective neuromodulatory treatment for TRD, a notable proportion of patients do not fully respond. Despite the clinical utility of rTMS, response variability remains a...
The brain can be modeled as a generative system that predicts bodily and environmental input and reduces mismatch through updating and action. From this perspective, stress is treated not as prediction error per se, but as a condition in which mismatch persists without sufficient recalibration. Health is therefore defined not as the absence of symptoms, but as the preservation of...
This Hypothesis and Theory article draws on a targeted, non-systematic synthesis of relevant literature and does not report new empirical data. Suggestion-based interventions show clinical promise across several medical conditions, yet their uptake in routine care remains limited. Psychiatry may be a particularly informative context in which to examine framing-related barriers because treatment...
Depression is a common complication after stroke. Although prior studies suggest that mindfulness-based stress reduction (MBSR) may alleviate depressive symptoms in post-stroke patients, the evidence remains inconclusive. This meta-analysis aimed to synthesize randomized controlled trials (RCTs) to evaluate the effects of MBSR on depressive symptoms after stroke. PubMed, Web of Science, Embase,...
Modern psychotherapy increasingly integrates multimodal and process-based approaches designed to respond to the complexity of contemporary clinical presentations. This paper introduces a three-pillar psychotherapeutic model combining (1) a revised cognitive behavioral foundation, (2) consciousness activation techniques derived from hypnosis, and (3) yoga-inspired postural and interoceptive...
Ruminations are persistent, repetitive, and often distressing thoughts centered on negative events, mood states, and psychiatric symptoms. Recognized as a maladaptive cognitive process, ruminating contributes to the onset and persistence of psychiatric disorders and is strongly linked to negative emotional states, self-criticism, and suicidality. Despite its clinical significance, a...
To evaluate the association of a short-term mindfulness-based stress reduction program combined with auricular acupressure with preoperative sleep fragmentation, anxiety, pain, and physiological stress responses in patients with spinal metastases using a retrospective quasi-experimental before-and-after design. This retrospective quasi-experimental before-and-after cohort study included...
Despite growing interest in mindfulness-based interventions (MBI) for Generalized Anxiety Disorder (GAD), robust evidence for their adjunctive use alongside first-line pharmacotherapy is scarce. This study aimed to evaluate the efficacy of MBI as adjunct to pharmacotherapy in adults with GAD, assessing multidimensional outcomes. In this randomized controlled trial, 106 adults diagnosed with...
Biological psychiatry faces a significant epistemic challenge in identifying valid objects for mechanistic research. Both diagnostic constructs and individual symptoms are abstract symbols defined circularly within a closed hermeneutic system, creating a symbol grounding problem that hinders the discovery of biophysical substrates (biomarkers). I argue that progress requires an epistemological...
Dissociation is a complex and transdiagnostic phenomenon defined as a disruption of, or discontinuity in, the normal, subjective integration of one or more aspects of psychological functioning. Dissociation has been identified as one of the most frequently occurring adverse effects associated with the use of esketamine nasal sprays. Individuals with high trait dissociation may be at a higher...