Annals of General Psychiatry
November 26, 2023
Giuseppe Maina, Marina Adami, Giuseppe Ascione et al.
56 citations
A Delphi panel of 60 Italian psychiatrists found wide variation in how treatment-resistant depression (TRD) is managed in Italy, highlighting a need for standardized strategies and treatments specifically approved for TRD. High consensus emerged on adding lithium or antipsychotics as augmentation therapies and on the need for long-term maintenance therapy. Esketamine nasal spray was identified as the best option for TRD patients, with agreement that it can be administered in a community outpatient setting given appropriate educational support for patients.
Annals of General Psychiatry
February 3, 2023
Daniël J. Siegel, Chloe Drulis
44 citations
This article presents an Interpersonal Neurobiology (IPNB) perspective, arguing that mental health and well-being are grounded in integration—the linkage of differentiated parts—and that the mind is both relational and embodied. The authors contend that the self extends beyond the individual, inextricably connected to social, cultural, and planetary systems. IPNB is described as a framework, not a therapy, drawing on physics, mathematics, neuroscience, and psychology. The article emphasizes psychache as an underlying cause of suicide and links it to personal, public, and planetary health, offering principles for clinical evaluation and treatment applicable across theoretical orientations.
Annals of General Psychiatry
May 17, 2020
Louise Morgan
27 citations
A review of research into MDMA-assisted psychotherapy for treatment-resistant PTSD found that small-scale studies show reduced psychological trauma, but there is widespread misunderstanding that MDMA itself is a treatment for PTSD, which has not been researched. This misunderstanding leads to harmful media reporting and impedes research. The authors conclude that MDMA-assisted psychotherapy may help people who have not resolved their problems through existing treatments, but more research is needed, and accurate reporting is essential.
Annals of General Psychiatry
May 8, 2024
Xiao-Fen Fan, Ju-Yi Peng, Li Zhang et al.
13 citations
Adolescents with depression who self-harm often rely on negative coping strategies and may benefit from positive alternatives. A combination of mindfulness therapy and mentalization-based family therapy (MBFT) was tested against MBFT alone in 80 hospitalized adolescents with depressive disorder and suicidal ideation, randomly assigned to two groups of 40. After intervention, both groups showed lower scores on psychological health and suicidal ideation scales, but the group receiving both therapies had significantly greater improvements. The findings suggest that adding mindfulness therapy to MBFT can improve psychological condition and reduce suicidal thoughts in this population, supporting its clinical use.
Annals of General Psychiatry
January 21, 2026
Mohammed A Alhassan
Treatment-resistant depression (TRD) remains a major clinical challenge in Gulf Cooperation Council (GCC) countries, where conventional therapies often yield incomplete remission and cause significant side effects. Ketamine, esketamine, and repetitive transcranial magnetic stimulation (rTMS) show clinical efficacy and feasibility in the region. Esketamine adoption is increasing, led by the United Arab Emirates and Qatar, where it is administered in controlled clinical settings. rTMS is being gradually integrated, with expansion through private providers in the UAE and Hamad Medical Corporation in Qatar. However, access is limited by regulatory challenges, high costs, infrastructure constraints, cultural stigma, limited insurance coverage, and workforce shortages. Strategic investments, policy reforms, and awareness initiatives are critical to embedding these treatments into mental health systems.
Annals of General Psychiatry
November 25, 2025
Luisa de Risio, Alessio Mosca, Arianna Pasino et al.
Anomalous self-experiences (ASEs), disturbances in the sense of a minimal self, are considered a core feature of primary psychotic disorders (PPDs) like schizophrenia, but it was unclear whether they also occur in substance-induced psychosis (SIP). This study compared ASEs in 27 clinically stable patients with schizophrenia spectrum disorders (SSD, mean age ~27) and 27 with SIP (mean age ~28) using the EASE interview. Total ASE scores did not differ between groups. However, SIP patients showed significantly higher disturbances in self-world boundary (Domain 4), while SSD patients trended higher in self-awareness and presence (Domain 2) and existential reorientation (Domain 5). These findings suggest ASEs are not exclusive to primary psychoses and challenge the assumption that self-disorders are unique to endogenous psychosis.
Annals of General Psychiatry
March 17, 2025
Maurizio Pompili, Isabella Berardelli, Denise Erbuto et al.
Major depressive disorder (MDD) is a leading cause of disability globally, with prevalence twice as high in women as in men. Mental pain, distinct from depression, is a crucial framework in MDD that may precipitate suicide risk. According to Panksepp's emotional theory, the opioid system influences feelings tied to grief and separation, making it a renewed target for antidepressant treatment. Antidepressants with partial mu-opioid receptor agonism and kappa-opioid receptor antagonism could address unmet needs. The combination of dextromethorphan and bupropion is a well-tolerated, rapid-acting treatment for adults with MDD. It is hypothesized that this combination reduces mental pain by targeting the opioid system, potentially improving treatment outcomes.