Among recent-onset hallucinogen users aged 12 to 21, a small minority (2%) showed a pattern resembling a hallucinogen dependence syndrome, while 88% expressed few or no clinical features of dependence. A further 10% may be at risk or in an early stage of dependence. Susceptibility to rapid transition from first use to dependence syndrome appeared to be influenced by the specific hallucinogenic compound taken: users of MDMA had an estimated relative risk of 2.4 compared to users of LSD. Excess risk did not appear to depend on age, sex, or race/ethnicity.
Adding mindfulness-based cognitive therapy (MBCT) to treatment as usual (TAU) for adults with bipolar disorder is likely cost-effective compared to TAU alone. Over 15 months, total societal costs were €615 lower for the MBCT-plus-TAU group, and healthcare costs differed significantly between groups. A small gain in quality-adjusted life years (QALYs) combined with lower costs (€836 after adjustment) made MBCT-plus-TAU the dominant strategy. The probability that the combination was cost-effective was 65%. Sensitivity analyses confirmed the robustness of these results. The difference in clinical effect was small or negligible, but the intervention still reduced overall costs.
A single 75 mg intranasal dose of ketamine reduces acute suicidal thoughts more than a 4 mg dose of the active placebo midazolam, measured 180 minutes after administration. The double-blind randomized trial includes 100 patients presenting with acute suicidality regardless of psychiatric diagnosis. The primary outcome is the change in suicidal ideation using the Beck Scale for Suicide Ideation. Secondary outcomes assess depression severity, tolerability, and biological markers. The study design addresses patient selection, ketamine formulation, clinical management, and follow-up timing.
The eight-factor structure of the Psychedelic Experience Scale (PES48), which includes the Mystical Experience Questionnaire (MEQ30) and additional factors for paradoxicality, connectedness, visual experience, and distressing experience, is valid for use in English. Analysis of 280 measurements from 145 healthy participants in four placebo-controlled psilocybin studies found that six subscales have high internal consistency, one good, and one acceptable. Both the MEQ30 and MEQ40 models show acceptable to good model fits, with better fits in English than in German. All six MEQ40 scale means were higher in English data, suggesting that the PES48 provides a broader conceptualization of mystical and non-mystical psychedelic experiences, and that setting may influence mystical experience.