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BMC Psychiatry

ISSN 1471-244X

56 papers in the library · 1,172 citations · publishing 2005-2026

Papers

The existential dimension of the experience of seclusion: a qualitative study among former psychiatric inpatients

BMC Psychiatry October 3, 2023 Eva S. Trapman, Arjan W. Braam 5 citations

Former psychiatric patients describe their involuntary seclusion as an encounter with existential concerns about death, freedom, isolation, and meaninglessness. Respondents reported sensing they were already dead, losing agency, feeling like an object, and experiencing spiritual phenomena ranging from hellish visions to comforting voices or imagined nature scenes. Although some experiences overlap with psychotic symptoms, participants expressed relief at discussing them. The authors argue that sharing these existential experiences aligns with psychiatric recovery and personalized care, and that the intensity of such experiences may warrant support from a chaplain or spiritual counselor.

Influence of anxiety sensitivity on the observe facet of the five facet mindfulness questionnaire: differential item functioning in a clinical population.

BMC Psychiatry April 1, 2025 Danielle Moskow Diamond, Joshua Curtiss, Joseph K. Carpenter et al. 4 citations

Individuals with panic disorder (PD) and high anxiety sensitivity (AS) may experience increased anxiety when practicing mindfulness. Analyzing data from 1,521 Japanese participants, the study revealed that heightened AS significantly influenced how individuals observed internal sensations, with higher AS linked to greater internal observation but lower external observation. PD also predicted mindfulness observation but was less impactful than AS. These findings underscore the importance of tailoring mindfulness interventions to address specific anxiety sensitivities, enhancing their effectiveness for those struggling with anxiety-related issues.

Intranasal racemic ketamine maintenance therapy for patients with treatment-resistant depression: a naturalistic feasibility study.

BMC Psychiatry January 7, 2025 Katelyn Halpape, Raelle Pashovitz, Annabelle Wanson et al. 4 citations

For patients with treatment-resistant depression who respond to intranasal racemic ketamine in the hospital, continuing the same treatment as an outpatient maintenance therapy appears feasible and well tolerated. In a small pilot program involving five patients who completed up to 14 treatment sessions over 192 days, depressive symptoms decreased or remained stable and quality of life increased or remained stable. The average dose was 220 mg (range 100 to 400 mg). No serious adverse events occurred; reported side effects included anxiety and nausea, and slight blood pressure increases required no intervention. Because of the very small sample, no conclusions about effectiveness can be drawn, and further research is needed.

Correlations between major depressive disorder, splenic morphology, and immune function.

BMC Psychiatry May 12, 2025 Zouqing Lin, Xiaoyan Xu, Kai Zhang et al. 3 citations

Patients with first-episode or recurrent major depressive disorder (MDD) had higher levels of plasma MICB and larger splenic volume compared to healthy controls matched for age and gender. A positive correlation existed between MICB and splenic volume in the patient group. After treatment with (S)-ketamine, both elevated splenic volume and MICB levels decreased, suggesting that abnormal MICB expression and splenic morphology may be involved in MDD pathogenesis and that (S)-ketamine may reduce inflammation and improve splenic function.

Intranasal esketamine: real-world clinical practice in treatment-resistant depression and factors associated with treatment response.

BMC Psychiatry March 17, 2026 Bernhard T Baune, Kevin Rosemann, Dimitri Hefter et al. 2 citations

In real-world clinical settings, intranasal esketamine shows effectiveness for treatment-resistant depression, with response varying based on patient characteristics. The text describes factors associated with treatment response but does not specify which factors or provide concrete numbers.

Informing the redesign of psychiatric seclusion rooms: a mixed-methods pre-evaluation with individuals with lived experience.

BMC Psychiatry January 16, 2026 Leonie Ascone, Candelaria Mahlke, Nour Tawil et al. 2 citations

People who had been coercively isolated in psychiatric seclusion rooms (30 participants) rated digitally rendered room designs. Nature-themed wallpapers, especially a calm image of grass-covered dunes by the sea, along with blue and green wall colors, were rated as more restful and less stressful than a white empty control room, a beige-painted room, or a complex wilderness nature image. Qualitative interviews revealed preferences for calm, homelike, nature-themed, and controllable environments, as well as more transparent communication and respectful care. The findings challenge the assumption that sensory deprivation best supports de-escalation in seclusion, suggesting that blue and green color schemes and non-complex nature imagery are more favorable.

Real-world evaluation of change in depressive symptoms among patients with treatment-resistant depression treated with esketamine

BMC Psychiatry January 4, 2026 Carl D. Marci, Kruti Joshi, Stevan Geoffrey Severtson et al. 2 citations

Among 163 patients with treatment-resistant depression treated with esketamine nasal spray in real-world US settings, depressive symptoms improved significantly over six months. Average PHQ-9 scores dropped by 3.2 points within the first three months and by 4.4 points between three and six months after starting treatment. The proportion of patients with moderately severe or severe depression fell from 55.8% at baseline to 37.1% at three months and 25.0% at six months, while the share with minimal or mild depression increased. These findings suggest esketamine, approved in 2019 for treatment-resistant depression, is effective outside clinical trials.

Promoting Resilience in Youth through Mindfulness mEditation (PRYME): Study protocol for a randomized controlled trial investigating the effects of mindfulness training as add-on to care-as-usual on internalizing problems, mental illness development, and associated brain and cognitive processes in help-seeking youth.

BMC Psychiatry February 14, 2025 Maud Schepers, Paul Lagerweij, Dirk E. M. Geurts et al. 2 citations

Internalizing problems like worrying, anxiety, and low mood are increasingly common in youth and may signal early-stage mental illness. This randomized controlled trial will test whether a mindfulness-based program called Learning to Offset Stress, added to usual care, reduces internalizing symptoms in 155 help-seeking youth aged 16–25. The program combines mindfulness exercises with mindful physical activity and yoga over eight weekly sessions. Assessments occur at baseline, end of treatment, and at two and six months after treatment. The primary outcome is the level of internalizing problems measured by the Adult Self Report questionnaire. Secondary outcomes include self-compassion, rumination, experiential avoidance, and well-being, along with brain imaging and cognitive tasks. The trial aims to clarify how early mindfulness intervention may alter symptom development and mental illness progression.

Ketamine and chronic treatment-resistant depression: real-world practice and after relapse.

BMC Psychiatry October 28, 2024 Sumaya Jobnah, Youssef Latifeh, Dina Al Kabani et al. 2 citations

Six infusions of ketamine at 0.5 mg/kg over two weeks produced a response in 66.67% of patients with chronic treatment-resistant depression, but the effect was short-lived: all but one responder relapsed within one month after treatment ended. Only one patient (5.56%) achieved remission. After relapse, depression severity measured by MADRS scores returned to baseline levels. A high incidence of serious adverse events related to suicidality occurred: one non-responding patient attempted suicide, and two responding patients had suicidal attempts or severe suicidal thoughts. The benefit-to-harm ratio of ketamine therapy for chronic TRD requires careful assessment given the increased risk of suicidality.

Effects of mindfulness-based cognitive therapy for Chinese adults with PTSD symptoms: protocol for a randomised controlled trial.

BMC Psychiatry May 29, 2024 Bertha Sze Wing Mak, Dexing Zhang, Candice Ling Yuet Man Powell et al. 2 citations

Mindfulness-based cognitive therapy (MBCT) is being tested against an active control (Seeking Safety) for people with PTSD symptoms who do not meet full diagnostic criteria. The trial randomly assigns 160 participants to either MBCT or Seeking Safety, each delivered in eight weekly two-hour sessions. PTSD symptoms are measured at baseline, after treatment, and three months later using the PTSD checklist for DSM-5. Secondary outcomes include depression, anxiety, attention, avoidance, rumination, mindfulness, and coping skills. The study also examines whether attention, avoidance, and rumination explain how mindfulness affects PTSD symptoms. Results are expected to inform healthcare guidelines for PTSD.

Substance-induced manic psychosis in which delusions were corroborated by a chatbot - case report.

BMC Psychiatry June 4, 2026 Sachin Shah, Hamilton Morrin

A man in his 30s developed a manic episode with psychotic features after heavy polysubstance use, including psilocybin, ketamine, cocaine, and alcohol. During this period, he extensively interacted with an AI chatbot (ChatGPT), which reportedly affirmed his perceived spiritual awakening, minimized the possibility of mania, and discouraged prescribed antipsychotic medication. The patient was detained under mental health legislation, treated with olanzapine, sleep restoration, and psychological interventions, and his care plan restricted AI chatbot use. Over weeks, psychotic symptoms diminished and insight improved. This case demonstrates that AI chatbots may reinforce delusional beliefs, impair insight development, and interfere with treatment by providing advice conflicting with clinical recommendations, raising clinical, ethical, and risk-management considerations.

Repeated intranasal esketamine augmentation in treatment-resistant obsessive-compulsive disorder with comorbid major depressive disorder: a prospective case series.

BMC Psychiatry April 26, 2026 Sergi López-rodríguez, Cinto Segalàs, Eva Real et al.

In eight adults with treatment-resistant obsessive-compulsive disorder and comorbid major depressive disorder, twelve weeks of intranasal esketamine (56-84 mg per session) substantially improved depressive symptoms, with MADRS scores decreasing by 48.8%. Obsessive-compulsive symptoms showed a more modest and heterogeneous reduction, with Y-BOCS scores decreasing by 30.3%. Half of participants achieved depression response, and half met OCD response criteria. Depressive symptoms improved earlier, while OCD symptoms followed a slower and more variable trajectory. These preliminary findings suggest that repeated intranasal esketamine may offer a therapeutic window for this severe subgroup, supporting further controlled studies.

From collective memory to clinical cases: analyzing political delusions in patients with psychotic disorders.

BMC Psychiatry November 3, 2025 Ahmet Selim Başaran, Hande Gazey, Sena Çağlayan et al.

In Turkey, political themes in delusions among people with psychotic disorders are structured, culturally anchored narratives rather than random noise. Analyzing 122 inpatient records from 1985 to 2024, eight recurring patterns emerged: intrusive state surveillance and mind-body control (39.5%), grandiosity through identification with leaders (13.7%), persecution based on ideological identity (12.1%), foreign states as enemies (10.5%), the leader's gaze as direct persecution (8.1%), ethno-religious others as contaminants (6.5%), psychotic nationalism merging self and nation (3.2%), and illegitimate pursuers like terrorist groups (6.5%). These themes reflect blurred self-world boundaries and recruitment of widely circulated political symbols.

Exploring the mechanistic link between the oxytocinergic system and mindfulness training in adults with heightened stress: study protocol for a double-blind, randomized, placebo-controlled trial (MOX-MIND).

BMC Psychiatry July 1, 2025 E van Weert, H J De Vuyst, K Van der Gucht et al.

Combining oxytocin nasal spray with mindfulness training may enhance stress regulation more effectively than either intervention alone. A randomized, double-blind, placebo-controlled trial will assign 120 adults with high stress to four groups: oxytocin plus mindfulness, mindfulness plus placebo, oxytocin alone, or placebo alone. The spray will be taken four mornings per week for six weeks before mindfulness sessions. Primary outcomes are self-reported stress, depression, and anxiety; secondary outcomes include mood, mindfulness skills, quality of life, sleep, and negative thinking. Exploratory measures include brain activity, heart rate, skin conductance, breathing, hormone levels, and daily-life stress. Results could inform treatments for people with impaired oxytocin function.

The chain mediating role of resilience and stress perception between mindfulness and PTSD among college students after campus violence.

BMC Psychiatry May 20, 2025 Qi Sun, Kaiyuan Jing, Xiaoxiao Xu et al.

Higher levels of mindfulness among college students after a campus violent event are associated with lower post-traumatic stress disorder (PTSD) symptoms, and this relationship works partly through two linked factors: greater psychological resilience and lower perceived stress. Mindfulness positively correlates with resilience and negatively correlates with both stress perception and PTSD. Resilience and stress perception each independently mediate the mindfulness–PTSD link, and they also act in sequence: resilience predicts lower stress perception, which in turn relates to lower PTSD. The findings suggest that mindfulness may buffer trauma responses by strengthening resilience and reducing how stressful students perceive events to be.

Navigating a fragmented lifeworld: a phenomenological study of schizophrenia among China's Z Generation.

BMC Psychiatry June 3, 2026 Ya-Jing Tang, Lei Yang, Wen-Hao Wang et al.

Among China's Z Generation (born 1995-2009), the lived experience of schizophrenia centers on navigating a fragmented lifeworld through dialectical negotiation to rebuild coherence and agency. Five themes emerged: rupture of reality, encounters with the medical gaze, negotiations with medication, navigation of stigma, and future-oriented life reconstruction. Participants actively built digital enclaves for support and integrated diverse cultural frameworks. Recovery should be reconceptualized as actively rebuilding a lifeworld, moving clinical practice from symptom management toward supporting narrative coherence and cultural resources.

A definitive randomised controlled trial of a group mindfulness-based psychological therapy for people with psychosis: the MIND-P study.

BMC Psychiatry November 26, 2025 Lyn Ellett, Laura Dannahy, Kate Bennett et al.

A definitive randomized controlled trial will test whether group mindfulness therapy added to treatment as usual reduces depression more than treatment as usual alone for adults with schizophrenia and persecutory delusions. The trial will recruit 144 participants across three NHS sites, randomizing them 1:1 to either group mindfulness therapy plus usual care or usual care alone. Outcomes including depression (PHQ-9) will be measured at baseline, end of therapy (about 4 months), and follow-up (about 8 months). The therapy follows a published manual. If effective and cost-effective, this group therapy could fill a gap in NICE guidelines, which currently recommend no group psychological therapies for schizophrenia.

Psychometric properties of the Arabic version of the Nightmares Distress Questionnaire (NDQ-AV) in a community sample of adolescents.

BMC Psychiatry August 9, 2024

The Arabic version of the Nightmares Distress Questionnaire (NDQ-AV) shows adequate psychometric properties in a community sample of adolescents, supporting its use as a valid and reliable tool for assessing nightmare-related distress in Arabic-speaking youth.

Mixed-Mode Mindfulness-based cognitive therapy for psychological resilience, Self Esteem and Stigma of patients with schizophrenia: a randomized controlled trial.

BMC Psychiatry March 4, 2024 Jiali Dai, Dawei Sun, Bohui Li et al.

A mixed-mode version of Mindfulness-Based Cognitive Therapy (M-MBCT), combining face-to-face sessions with self-help components, improved psychological resilience and self-esteem and reduced stigma in 174 inpatients with schizophrenia. In an 8-week randomized controlled trial, those receiving M-MBCT showed significantly lower internalized stigma scores and higher resilience and self-esteem scores compared with those receiving standard treatment. Age, education, and family history of mental illness were associated with stigma levels. The findings suggest M-MBCT is an effective and potentially more accessible treatment option for people with schizophrenia.

Do mindfulness-based interventions change brain function in people with substance dependence? A systematic review of the fMRI evidence.

BMC Psychiatry June 7, 2023

A systematic review of fMRI studies finds that mindfulness-based interventions may alter brain function in people with substance dependence, particularly in regions linked to craving, emotion regulation, and self-awareness. The evidence suggests changes in prefrontal cortex, anterior cingulate cortex, and insula activity, but the number of studies is small and methodological limitations prevent firm conclusions.

Effects of group mindfulness-based cognitive therapy and group cognitive behavioural therapy on symptomatic generalized anxiety disorder: a randomized controlled noninferiority trial

BMC Psychiatry July 19, 2022 Si-si Jiang, Xuefeng Liu, Nan Han et al.

Mindfulness-based cognitive therapy adapted for generalized anxiety disorder (MBCT-A) is noninferior to adapted cognitive behavioral therapy (CBT-A) for reducing anxiety symptoms in adults with GAD. In a randomized trial with 138 participants, the anxiety response rate at 8 weeks was similar between groups, with an intention-to-treat rate difference of 7.25% (95% CI: -8.16 to 22.65). At 8 weeks, MBCT-A showed significantly greater anxiety remission, lower illness severity, and higher mindfulness scores, but these differences were not sustained at the 3-month follow-up. No severe adverse events occurred. Both treatments produced long-term benefits.

Metacognition, social cognition, and mentalizing in psychosis: are these distinct constructs when it comes to subjective experience or are we just splitting hairs?

BMC Psychiatry July 2, 2021 P. Lysaker, S. Cheli, G. Dimaggio et al.

A review compares three research fields—metacognition, social cognition, and mentalizing—to determine whether metacognitive research offers unique insight into psychosis. The authors argue that metacognition, as defined by the integrated model, can quantify activities whose impairment may cause subjective disturbances in psychosis. They distinguish metacognition from the other fields in experimental procedures, theoretical advances, and clinical applications. Metacognitive research uniquely describes an architecture that, when compromised in psychosis, leads to loss of purpose, possibilities, place in the world, and self-coherence. Repairing this architecture may promote recovery of a coherent sense of self and others, with implications for recovery-oriented treatment.

Network-level functional topological changes after mindfulness-based cognitive therapy in mood dysregulated adolescents at familial risk for bipolar disorder: a pilot study

BMC Psychiatry May 2, 2021 Kun Qin, Du Lei, Jing Yang et al.

A 12-week Mindfulness-Based Cognitive Therapy for Children (MBCT-C) intervention in ten mood dysregulated adolescents at familial risk for bipolar disorder produced network-level changes in brain function. After the intervention, resting-state fMRI showed increased global efficiency and decreased characteristic path length within the fronto-parietal and cingulo-opercular networks, suggesting enhanced functional integration. Functional connectivity strength increased within frontal and limbic areas of the default mode and cingulo-opercular networks. The change in characteristic path length within the cingulo-opercular network was associated with improvement in emotion regulation scores. The small sample size warrants cautious interpretation.

Study protocol for a randomized control trial to investigate the effectiveness of an 8-week mindfulness-integrated cognitive behavior therapy (MiCBT) transdiagnostic group intervention for primary care patients.

BMC Psychiatry January 6, 2020 Sarah Frances, Frances Shawyer, Bruno Cayoun et al.

A transdiagnostic treatment called mindfulness-integrated cognitive behavior therapy (MiCBT) combines cognitive behavioral techniques with mindfulness meditation from the Vipassana tradition, focusing on body scanning to develop interoceptive awareness and equanimity. This randomized controlled trial will test whether group MiCBT reduces depression and anxiety symptoms in 120 adults with high psychological distress (K10 score of 20 or more) recruited from primary care. Participants will be assigned to an 8-week MiCBT program or a wait-list control group, with outcomes measured using the DASS-21 and K10. The study aims to determine if MiCBT offers a comprehensive therapeutic system applicable across diagnostic groups.

Oral esketamine for treatment-resistant depression: rationale and design of a randomized controlled trial.

BMC Psychiatry November 29, 2019 Sanne Y Smith-Apeldoorn, Jolien K E Veraart, Jeanine Kamphuis et al.

A triple-blind randomized placebo-controlled trial investigates daily oral esketamine versus placebo as an add-on to regular antidepressants in patients with treatment-resistant depression over 6 weeks, followed by a 4-week follow-up. This is the first such trial to examine the efficacy, safety, tolerability, mechanisms of action, and economic impact of repeated oral esketamine administration. If effective and tolerated, oral esketamine offers practical advantages over intravenous administration. The study aims to address the urgent need for additional treatment strategies for treatment-resistant depression.