Current Psychiatry Reports
June 4, 2019
Ian Hamilton, Mark Monaghan
80 citations
Three hypotheses explain the association between cannabis and schizophrenia: cannabis can trigger schizophrenia, cannabis is used to mitigate schizophrenia symptoms, and common factors account for the association. Biological and genetic factors dominate research, while social and cultural contributions are underexplored. Evidence for cannabis as a causal factor for schizophrenia has not been established. Research must extend beyond males from western countries to advance understanding.
Current Psychiatry Reports
October 1, 2022
Gregory S. Barber, Scott T Aaronson
56 citations
For patients with mood disorders or PTSD who have not responded to multiple treatments, few options exist. After decades of federal restrictions on psychedelic research, recent studies have re-examined compounds like MDMA and psilocybin. These investigations involve safe administration in controlled settings, preceded by hours of participant preparation and followed by integration sessions. The improvements participants experience appear linked to profound shifts in perspective, distinct from those achieved with current standard care. Studies have addressed treatment-resistant depression, end-of-life despair, and PTSD. Psychedelic psychotherapy, combining biological therapy with psychotherapy, may transform mental health care.
Current Psychiatry Reports
October 1, 2003
John H. Halpern
42 citations
Hallucinogen research has largely focused on epidemiology and pathology, with little attention to religious or therapeutic uses. This paper reviews less familiar compounds like Salvia divinorum, MDMA (ecstasy), and synthetic hallucinogen analogs, along with the rare condition hallucinogen persisting perception disorder (flashbacks) and its treatment. Current clinical research and case vignettes suggest hallucinogens may have anti-addictive applications. Religious, nondrug use of hallucinogens as sacred sacraments in the US and elsewhere is also discussed. The authors argue that these physiologically nonaddictive drugs may offer legitimate societal benefits, and that methodologically sound research could support such benefits, helping clinicians address hallucinogen use with patients.
Current Psychiatry Reports
October 1, 2022
Damien Prouzeau, Ismaël Conejero, Peter L Voyvodic et al.
32 citations
Psilocybin shows large, rapid, and persistent clinical effects in treating resistant or end-of-life depression, with good tolerance and mild side effects limited to a few hours after dosing. However, studies to date have had small sample sizes, and one clinical trial against escitalopram did not show significant superiority of psilocybin on the main outcome. The neurobiological mechanisms, which differ from those of SSRI antidepressants, remain mostly unknown. Psilocybin is a promising alternative, but further research with larger samples and comparisons to standard treatments is needed.
Current Psychiatry Reports
April 1, 2024
John L. Havlik, Syed Wahid, Kayla M Teopiz et al.
30 citations
Treatment-resistant depression (TRD) has historically had very limited options, but recent advances have expanded knowledge of effective interventions. Psychotherapy can help as an add-on but not alone. Adjunctive non-antidepressant drugs like buprenorphine and antipsychotics show little recent support; side effects and high discontinuation rates may outweigh benefits. Strong recent evidence supports interventional approaches: electroconvulsive therapy, ketamine/esketamine, and transcranial magnetic stimulation. Research on TRD should use internationally defined inclusion criteria for generalizable results.
Current Psychiatry Reports
December 1, 2022
Natalie Gukasyan, Colleen C Schreyer, Roland R. Griffiths et al.
29 citations
Psychedelic-assisted therapy (PAT) may be safe and effective for various mental health conditions, including eating disorders such as anorexia nervosa. Classic psychedelics could have transdiagnostic benefits through mechanisms relevant to eating disorder pathology. Interest in and efforts to increase access to PAT are high, but early clinical trials are focused on safety and utility, with efficacy remaining unclear. High-quality published data supporting PAT for eating disorders is lacking, though recent studies suggest it may augment current interventions for these difficult-to-treat conditions.
Current Psychiatry Reports
October 1, 2023
Aaron Wolfgang, Charles W Hoge
15 citations
MDMA- and psilocybin-assisted therapy have shown promising outcomes for PTSD and depression, respectively. MDMA-assisted therapy is already FDA-approved on a compassionate use basis for PTSD, with full approval projected for 2024; psilocybin-assisted therapy is projected to be approved for depression soon after. The VA is conducting clinical trials, but implementation barriers include high clinical hours per patient, resource requirements, military-specific considerations, and the need for strong evidence before inclusion in clinical guidelines. Policymakers in the DoD and VA must prepare clear policies for these treatments as FDA approval approaches.
Current Psychiatry Reports
June 1, 2025
Amishi P. Jha, Mary K Izaguirre, Amy B Adler
9 citations
Mindfulness training may protect and strengthen military service members' attentional control, improving performance and holistic fitness. Implementation challenges must be addressed to realize benefits consistently at scale. Despite variation in program content, evaluation metrics, and participants' career stages, recent findings suggest mindfulness training can bolster performance, cognitive functions, psychological well-being, and social relationships. Implementation factors such as daily practice, trainers' familiarity with the military, and course content influence the extent of benefits. Attentional control is critical for effective performance yet vulnerable in high-demand cohorts like military personnel. Best practice guidance is emerging, and continued research and implementation efforts are warranted.
Current Psychiatry Reports
November 1, 2024
Matthew J Reid, Hannes Kettner, Tessa F. Blanken et al.
4 citations
Psilocybin is an emerging treatment for depression, but its effects on sleep are not well understood. Clinical trials show large improvements in depressive symptoms, but sleep quality or insomnia symptoms have not been directly studied. Preliminary data indicate that both depressive symptoms and sleep disturbances decreased significantly after psilocybin use, though sleep improvements were smaller than those for depression. More severe sleep disturbances at baseline were linked to a lower probability of depression remission, suggesting a potential interaction between sleep and psilocybin's efficacy. Addressing sleep disturbances could enhance therapeutic outcomes and lead to more personalized treatment strategies.
Current Psychiatry Reports
February 1, 2025
Andrew B. Newberg
3 citations
Neurotheology, the study of the brain's relationship with religious and spiritual phenomena, can serve as a bridge between understanding how spirituality and religion affect brain function and how this relates to mental health changes. Research shows that religious and spiritual beliefs, practices, and experiences can profoundly impact the psyche, often positively by lowering depression, anxiety, and distress, but sometimes negatively by fostering harmful beliefs or behaviors. This field examines both positive and negative effects from a brain perspective and offers philosophical insights into the mind and perception of reality. The review evaluates these topics and considers practical applications for integrative psychiatry.
Current Psychiatry Reports
February 1, 2025
Jamarie Geller, Eric Whitney
3 citations
Clinical trials show psilocybin-assisted psychotherapy for adults with depression and MDMA-assisted psychotherapy for adults with PTSD yield encouraging results, including for treatment-resistant depression and durable remission rates. No studies have examined these treatments in adolescents. Given the high burden of untreated psychiatric illness in youth, investigating safety and efficacy in younger patients is recommended, with research and implementation tailored to adolescent needs and equity considered at every stage.
Current Psychiatry Reports
December 1, 2024
Daan de Jonge, Pim B. van der Meer, Cornelis Kramers et al.
2 citations
A narrative review of psilocybin- and LSD-assisted treatment for alcohol use disorder (AUD) and major depressive disorder (MDD) finds growing evidence that psilocybin produces a sustained reduction in drinking frequency among people with AUD, and a recent meta-analysis shows psilocybin therapy yields a large and consistent decrease in depressive symptoms compared to no treatment. AUD and MDD frequently co-occur, and this comorbidity worsens symptoms of both disorders and complicates treatment. The authors argue that an integrated therapy addressing both conditions simultaneously could benefit such patients and call for more research on psilocybin in this dual-diagnosis population.
Current Psychiatry Reports
May 14, 2026
Jamarie Geller, Rachel M Pacilio, Amanda E. Downey et al.
Psilocybin-assisted therapy may hold promise for anorexia nervosa, a serious and often treatment-resistant illness. Although research has focused on adults, anorexia frequently begins in adolescence, and early onset is linked to more severe illness, greater psychiatric comorbidity, and more life difficulties. The authors argue that exploring the theoretical potential of this therapy for adolescents is warranted, considering biological implications, developmental stage, and consent. They propose adaptations to adult treatment models and discuss emerging models that address the unique challenges of adolescent patients.
Current Psychiatry Reports
November 1, 2025
Christine J So, Courtney J Bolstad, Katherine E Miller
Nightmares that persist after trauma often require targeted treatment, as trauma-focused therapies for PTSD may not fully resolve them. Imagery rehearsal therapy and the medication prazosin remain the most supported interventions, though results vary across studies. New consensus guidelines have produced Cognitive Behavioral Therapy for Nightmares, which combines rescripting, exposure, and sleep strategies. Emerging approaches such as digital self-management, brief coaching, lucid dreaming, and targeted memory reactivation show promise. Integrated treatments that sequence nightmare care with PTSD or insomnia therapies may improve outcomes, but evidence is mixed. The field needs standardized CBT-based approaches, consistent outcome measurement, and research on mechanisms and sequencing to optimize and expand access to nightmare treatment.
Current Psychiatry Reports
October 11, 2018
Scott H Waltman, David Shearer, Bret A Moore
Post-traumatic nightmares are a common and distressing problem for people with PTSD and other conditions, linked to high costs and an independent risk of suicide. An updated review finds that Prazosin, previously a preferred pharmacological treatment, has been downgraded by the American Academy of Sleep Medicine and the Veterans Health Administration/Department of Defense following a recent New England Journal of Medicine study. In Canada, Nabilone, a synthetic cannabinoid, appears promising. Non-pharmacological options like imagery rescripting therapy and exposure, relaxation, and rescripting therapy remain preferred, with recent evidence supporting their use in inpatient settings, with German combat veterans, via virtual technology, and with children and individuals with bipolar disorder. Combining cognitive behavior therapy for insomnia with these therapies may improve outcomes.
Current Psychiatry Reports
February 1, 2016
Charles Ksir, Carl L. Hart
A review of recent research on cannabis and psychosis examines two competing hypotheses: cannabis as a contributing cause of psychosis and a shared vulnerability between cannabis use and psychosis. The evidence suggests that cannabis does not in itself cause a psychotic disorder. Instead, both early and heavy cannabis use are more likely in individuals who already have a vulnerability to psychosis. The role of early and heavy cannabis use as a prodromal sign, along with other problem behaviors such as early or heavy use of cigarettes or alcohol and poor school performance, merits further examination. Future studies focusing solely on the cannabis-psychosis association will be of little value in understanding psychosis.
Current Psychiatry Reports
February 1, 2016
Michael Schredl
Research on dreaming in people with personality disorders is limited, but studies of borderline personality disorder show that these patients experience negatively toned dreams and more frequent nightmares, and these characteristics are not caused by co-occurring depression or posttraumatic stress disorder. The review suggests future research directions, noting that current findings make this area of study promising. Clinical recommendations focus on treating the commonly co-occurring nightmare disorder.
Current Psychiatry Reports
October 1, 2012
Monica Escamilla, Mercedes LaVoy, Bret A Moore et al.
Nightmares affect most healthy adults and many clinical populations, especially trauma survivors. Over the past decade, treatments for post-traumatic nightmares have advanced. The medication prazosin shows strong clinical effects with few side effects. Among psychological approaches, imagery rehearsal therapy has the most research support due to its proven effectiveness. This review covers these treatments and suggests directions for future research.
Current Psychiatry Reports
June 1, 2007
C Choong, M D Hunter, P W R Woodruff
Auditory hallucinations occur in people who do not have schizophrenia, and they are not exclusive to psychiatric illness. While such experiences are present in the general population, they differ fundamentally from those in clinical populations. In psychiatric patients, hallucinations tend to be frequent, intrusive, and distressing, whereas in nonclinical individuals they are often positive and nonthreatening. The exact mechanism behind auditory hallucinations remains unknown, but studying them in healthy people may help clarify the processes underlying clinical conditions.
Current Psychiatry Reports
June 1, 2005
Raffaele Manni
Dreaming occurs during both REM and NREM sleep, not only during REM sleep as long thought. Hallucinatory activity during sleep is normal and increases toward morning, becoming equally present in REM and NREM sleep. In narcolepsy, hypnagogic hallucinations arise from a REM-dissociation state where dream imagery intrudes into wakefulness. Similar mechanisms may contribute to visual hallucinations in various neuropsychiatric disorders. Evidence suggests that both REM and NREM processes, including arousal-related processes, play a role in hallucinations, particularly in delirium tremens and Parkinson's disease.
Current Psychiatry Reports
June 1, 2005
Christine Mohr, Olaf Blanke
Autoscopic phenomena—rare illusory experiences of seeing a second own body in extrapersonal space—include out-of-body experiences, autoscopic hallucinations, and heautoscopy. Neurologic evidence points to deficits in multisensory integration of body-related information and vestibular dysfunction at the temporo-parietal junction as underlying mechanisms. Their rarity has hindered research, but recent findings link them to mental own-body imagery engaging the same brain region. This review examines clinical syndromes—psychosis, depression, anxiety, depersonalization, body dysmorphic disorder—and suggests they may relate to proneness for autoscopic phenomena, offering testable propositions for future research on body and self processing.