Background Obsessive–compulsive disorder (OCD) is a debilitating mental disorder commonly treated with selective serotonin reuptake inhibitors, atypical antipsychotic augmentation and cognitive–behavioural therapy. However, up to 60% of people with OCD do not respond to these treatments. Therefore, a novel intervention, psilocybin-assisted psychotherapy (PAP), is an option of interest....
Background Psilocybin-assisted psychotherapy (PAP) has gained attention as a promising intervention for conditions including depression, anxiety and post-traumatic stress disorder, but understanding of its side-effects is limited. This review evaluates the quality of side-effects reporting in PAP trials, to guide treatment, policy and research. Aims To assess side-effects reporting quality in...
We provide preliminary support for the efficacy and tolerability of i.m. ketamine in a community sample of individuals with PTSD. Further work is required to establish the optimal dosing regimen and longer-term role of ketamine in treatment of PTSD, but our findings are encouraging given the well-known of treatments in this area.
Nitrous oxide may possess antidepressant effects; however, limited data exist on repeated administrations and active placebo-controlled studies in treatment-resistant depression (TRD). We aimed to test the feasibility of a randomised controlled trial examining a 4-week course of nitrous oxide or midazolam, an active placebo. In this randomised, active, placebo-controlled pilot trial, 40...
Aims: Ketamine and behavioural activation (BA) reduce levels of anhedonia in major depressive disorder (MDD), though neither resolves anhedonia. Combining these treatments could yield additive or even multiplicative benefits. This poster summarises the development of a PhD fellowship proposal, discussing: (1) the initial patient and public involvement (PPI) interviews, exploring views on...
Aims: 1. Examine efficacy and durability of antidepressant effects. 2. Identify specific symptoms of improvement. 3. Compare response rates and duration of antidepressant effects in failed to respond to previous treatments. Methods: Prospective review study of patients who received off-label rapid dissolve wafer for SL delivery in hospital setting 2–3 times a week for 4 weeks. The study...
Aims: Ketamine is a novel and exciting putative antidepressant medication for patients with treatment-resistant depression. A complication commonly seen in frequent and heavy recreational use of ketamine is ulcerative cystitis, which presents with lower urinary tract symptoms (LUTS) and upper renal tract damage and can be seen in over 25% of regular users. Although ketamine-induced cystitis...
BJPsych OpenJune 1, 2025Emeka Onochie, Joseph Verghese
Aims: Background: Depersonalization-derealization disorder (DPDR), classified under ICD–11 code 6B66, involves persistent or recurrent experiences of depersonalization, derealization, or both. Depersonalization refers to a sense of detachment from one’s thoughts, emotions, or body, whereas derealization involves perceiving the external world as unreal or distorted. These symptoms cause...
BJPsych OpenJune 1, 2025Zelda Summers, Jennie Rankine, Stuart Fisher
Aims: For patients prescribed methadone wishing to access buprenorphine ORT, the current practice is to reduce the methadone dose to 30/40 ml and cessation of methadone for 48 hrs prior to the switch. This exposes these patients to risk of psychological, physical distress or relapse into non-prescribed opiate use. Using guidance published by the Canadian Journal of Addiction we adapted this to...
Background Psilocybin is being investigated as a treatment for a myriad of disorders, including treatment-resistant depression. The main focus has been on positive effects, with little attention paid to negative outcomes, especially in clinical settings. Quantitative methodology limits further exploration of such events and can also miss improvements not captured on rating scales. Aims To...
BACKGROUND: Suicide is one of the major causes of premature death in patients diagnosed with a schizophrenia-spectrum psychotic disorder. However, associations between psychotic-like experiences in youth and suicidality in later life remain under-researched. AIMS: We aimed to investigate any associations between early experiences of thought interference and auditory-verbal hallucinations (AVHs)...
BJPsych OpenJune 1, 2024Bikramaditya Jaiswal, Neha Singh, Benson Benjamin
AimsThe primary aim of this rapid review was to evaluate the evidence base for the efficacy of ketamine across all formulations and routes of administrations in the treatment of adult patients with treatment resistant depression (TRD).MethodsThis rapid review retrieved controlled trials on use of ketamine across all of its formulations, including all isomers and across all routes of...
In this editorial, we emphasise the efficacy and challenges of using ketamine in treatment-resistant depression. We highlight the need for comprehensive evidence-based guidelines to manage the use of both licensed and off-licence ketamine formulations and discuss recent efforts by Beaglehole et al to develop ketamine guidelines in New Zealand. We finally advocate for national registries to...
Background The evidence base for racemic ketamine treatment for treatment-resistant major depressive disorder (TRD) continues to expand, but there are major challenges translating this evidence base into routine clinical care. Aim To prepare guidelines for ketamine treatment of TRD that are suitable for routine use by publicly funded specialist mental health services. Method We consulted with...
Background Randomised controlled trials (RCTs) of psilocybin have reported large antidepressant effects in adults with major depressive disorder and treatment-resistant depression (TRD). Given psilocybin's psychedelic effects, all published studies have included psychological support. These effects depend on serotonin 2A (5-HT2A) receptor activation, which can be blocked by 5-HT2A receptor...
Aims For patients with depression, the likelihood of remission decreases with each subsequent treatment failure. Per European Medicines Agency guidance, treatment resistant depression (TRD) is defined as nonresponse to ≥2 consecutive treatments at adequate dosage and duration in the current depressive episode. In ESCAPE-TRD (NCT04338321), esketamine nasal spray (NS) increased the probability of...
BJPsych OpenJuly 1, 2023Oluwatomiwa Ajayi, Arit Esangbedo, Abisola A. Lawal et al.1 citation
Aims Moral Injury is a strong cognitive and emotional response occurring upon witnessing, participating in, or failing to prevent an act that goes against one's ethical code. This has been linked with Post Traumatic Stress Disorder, Depression, Suicidality, and Anxiety, amongst others. Data on its association with Schizophrenia are however lacking. Trance and Possession Disorders defined by the...
Background Public and patient expectations of treatment influence health behaviours and decision-making. Aims We aimed to understand how the media has portrayed the therapeutic use of ketamine in psychiatry. Method We systematically searched electronic databases for print and online news articles about ketamine for psychiatric disorders. The top ten UK, USA, Canadian and Australian newspapers...
BACKGROUND: Ketamine is an effective short-term treatment for a range of psychiatric disorders. A key question is whether the addition of psychotherapy to ketamine treatment improves outcomes or delays relapse. AIM: To identify all studies combining psychotherapy with ketamine for the treatment of psychiatric disorders to summarise their effects and make recommendations for future research....
BJPsych OpenMarch 9, 2023Yonas Baheretibeb, Dawit Wondimagegn, Samuel Law
Background Religious and traditional healers remain the main providers of mental healthcare in much of Africa. Collaboration between biomedical and traditional treatment modalities is an underutilised approach, with potential to scale up mental healthcare. Aims To report the process and feasibility of establishing a collaboration between religious healers and psychiatrists in Addis Ababa,...
Background Meta-analyses show efficacy of mindfulness-based cognitive therapy (MBCT) in terms of relapse prevention and depressive symptom reduction in patients with major depressive disorder (MDD). However, most studies have been conducted in controlled research settings. Aims We aimed to investigate the effectiveness of MBCT in patients with MDD presenting in real-world clinical practice....
We examined the neural underpinnings of the effects of mindfulness on anxiety in anorexia nervosa using functional magnetic resonance imaging in 21 anorexia patients. We used a functional magnetic resonance imaging task designed to induce weight-related anxiety and asked participants to regulate their anxiety either using or not using an acceptance strategy. Our results showed reduced activity...
Dissociative behaviours and hallucinations are often reported in trauma-exposed people with schizophrenia spectrum disorders and post-traumatic stress disorder (PTSD). Auditory hallucinations are the most commonly reported type of hallucination, but often co-occur with experiences in other sensory modalities. The phenomenology and the neurobiological systems involved in visual experiences are...
BJPsych OpenNovember 15, 2022Petra Hanson, Maria Lange, Dominic Oduro-Donkor et al.
Background: Psychological stress has an established bi-directional relationship with obesity. Mindfulness techniques reduce stress and improve eating behaviours, but their long-term impact remains untested. CALMPOD (Compassionate Approach to Living Mindfully for Prevention of Disease) is a psychoeducational mindfulness-based course evidenced to improve eating patterns across a 6-month period,...
BJPsych OpenSeptember 23, 2022Amy S Badura Brack, Marika Marklin, Christine M Embury et al.
Background: Trait dissociation has not been examined from a structural human brain mapping perspective in healthy adults or children. Non-pathological dissociation shares some features with daydreaming and mind-wandering, but also involves subtle disruptions in affect and autobiographical memory. Aims: To identify neurostructural biomarkers of trait dissociation in healthy children. Method:...