Psychiatry International
October 15, 2024
Valerio Ricci, Giovanni Martinotti, Giuseppe Maina
9 citations
Substance-induced psychosis (SIP) is increasingly common, especially among adolescents and young adults using cannabis, cocaine, and novel psychoactive substances. This review examines how SIP differs from primary psychotic disorders by focusing on two key concepts: Gaëtan de Clérambault's "mental automatism," where involuntary thoughts and sensations feel alien to the self, and the "twilight state" of consciousness, marked by altered perception of space, time, and social interaction. These phenomena help explain how substance use triggers psychotic processes and how SIP can transition to persistent psychosis with frequent, potent use. The review advocates for a clinical–phenomenological approach to improve diagnosis and treatment.
Psychiatry International
September 20, 2024
Alessio Mosca, Stefania Chiappini, Andrea Miuli et al.
5 citations
Piperazines, synthetic compounds with stimulant and hallucinogenic effects, are linked to acute psychotic episodes. A systematic review of 4 studies found that piperazine abuse frequently triggers symptoms such as paranoia, auditory, and visual hallucinations. The compounds' complex polyreceptor action may explain these effects, similar to other novel psychoactive substances. Recovery is common after cessation and treatment, but data on long-term outcomes are limited. Further research into piperazine abuse and specific treatment protocols for substance-induced psychosis is needed.
Psychiatry International
June 15, 2026
Angel Labra-Lorenzana, Dania Nimbe Lima Sanchez, Christian Alejandro Delaflor-Wagner et al.
Psilocybin-assisted psychotherapy (PAP) is associated with large short-term reductions in depressive symptom severity among adults with major depressive disorder. A meta-analysis of ten clinical trials found an overall large effect (d = 1.15), with within-subject designs showing larger estimates (d = 1.63) than between-subject controlled comparisons (d = 0.96). Adverse events were transient and manageable, with no increased risk of serious adverse events on dosing days. However, long-term efficacy remains understudied, and the overall certainty of evidence is low to moderate. Larger, rigorously blinded trials are needed.
Psychiatry International
December 24, 2025
Valentina Baldini
Sleep disturbances, especially insomnia and nightmares, may help explain why traumatic experiences increase the risk of suicidal thoughts and behaviors. This review of epidemiological, clinical, and experimental studies finds evidence that alterations in REM sleep regulation, dysregulation of the hypothalamic–pituitary–adrenal axis, and impaired prefrontal control of emotional reactivity are potential mechanisms, though findings vary across populations. Trauma-related nightmares and persistent insomnia appear to be particularly strong markers of elevated suicide risk. Routine sleep assessment could improve suicide risk evaluation in trauma-exposed individuals. Interventions such as cognitive behavioral therapy for insomnia, imagery rehearsal therapy, and REM-modulating drugs show promise, but their specific effects on suicidality require further testing.