General Hospital Psychiatry - The Consciousness Library

Advancing cancer neuroscience through stress modulation: Interdisciplinary potential of psilocybin and ketamine

General Hospital Psychiatry February 25, 2026 Alan C. Courtes, Blake Myers, Noah Daly et al. 1 citation

Psychological stress not only undermines quality of life for people with cancer but also fuels tumor growth. Emerging evidence from the nascent field of cancer neuroscience suggests that adrenergic signaling from direct tumor-neuron interactions drives cancer progression, resistance to treatment, and worse outcomes. Cancer neuroscientists are increasingly seeking to repurpose psychoactive...

DOI: 10.1016/j.genhosppsych.2026.02.011

Ketamine combined with psychotherapy for treatment-resistant depression: Real-world outcomes and the role of subjective experience.

General Hospital Psychiatry 2026 Rebeca Cohen, João Bastos, Catarina Cunha et al. 1 citation

Ketamine, an N-methyl-d-aspartate antagonist, shows promise for treatment-resistant depression (TRD), with psychedelic doses potentially enhancing efficacy. However, its transient antidepressant effects and the need for repeated infusions raise concerns about optimal duration and long-term safety. Two clinical trials have tested the combination of ketamine with psychotherapy for depression,...

DOI: 10.1016/j.genhosppsych.2026.02.001 Full text Ego dissolution Ketamine Treatment-resistant depression Antidepressant +1

Making sense of desperation for treatment in decisions to use psychedelics for depression and anxiety: A qualitative Subreddit study anticipating clinical challenges.

General Hospital Psychiatry 2026 David T. Kryszajtys, Carol Strike, Brian Rush et al. 1 citation

Some individuals interpret persistent depression and anxiety, alongside the exhaustion of standard treatment options, as leading to a desperate need for relief. While desperation may shape how people assess treatment options, its role in psychedelic self-treatment and its relevance for emerging clinical models of psychedelic treatment remain underexplored. We collected discussion threads from...

DOI: 10.1016/j.genhosppsych.2026.02.002 Full text

Evaluating the potential risk of ketamine-induced hepatotoxicity in the treatment of mood and anxiety disorders: A systematic review.

General Hospital Psychiatry 2026 Gabrielle F. M. Lovell, Shreya Vasudeva, Diana Orsini et al.

Ketamine is a dissociative anesthetic with potential for treating mood, anxiety, and related disorders; however, concerns have emerged regarding hepatotoxicity in the context of chronic treatment. Systematic searches of PubMed, Scopus, and Ovid databases were conducted from inception to August 2025. Eligible studies included randomized controlled trials (RCTs), observational studies, and case...

DOI: 10.1016/j.genhosppsych.2026.04.005 Full text Esketamine Major depressive disorder Alanine aminotransferase Aspartate aminotransferase +2

Eligibility for psychedelic therapy: Clinical trial medical exclusion criteria and their implications for hospital practice.

General Hospital Psychiatry 2026 Martin L Williams, Karen Hitchcock, Angus H Miller et al.

Clinical research in psychedelic-assisted therapies is flourishing following the resumption of human trials exploring classic psychedelics and their therapeutic application to a range of mental health conditions. Translation from research to the clinic is underway in Australia and appears imminent in several other countries. Classic psychedelics function primarily as agonists of a subgroup of...

DOI: 10.1016/j.genhosppsych.2025.12.009 Full text Psychedelic-assisted therapy Classic psychedelics Drug-drug interactions Hospital practice +2

Challenges of enrolling participants with alcohol and opioid use disorders in the emergency department for clinical trials of ketamine: The experience from two randomized controlled trials.

General Hospital Psychiatry 2026 P R Chai, E Lee, M A Hasdianda et al.

Application of psychedelics including ketamine may be important adjuncts in the treatment of alcohol and opioid use disorders. Most patients with alcohol or opioid use disorder (AUD/OUD) may present to the emergency department (ED) seeking care both for substance use and associated complaints. Understanding safety and preliminary efficacy of ketamine and other psychedelics to improve the care...

DOI: 10.1016/j.genhosppsych.2025.12.019 Full text Alcohol use disorder Ketamine Opioid use disorder Clinical trials +2

Psychological support can be distinguished from psychotherapy: Clarifications for future empirical work.

General Hospital Psychiatry 2026 Jonathan R Schettino, Katherine Cheung, Sandeep M. Nayak et al.

Classic psychedelic studies involve interpersonal interactions with participants before, during, and after the acute effects of psychedelics. In the field of psychedelic research, there is currently a debate about whether this interpersonal interaction is most accurately considered "psychological support," "psychotherapy," or something else. Proponents of the psychological support label...

DOI: 10.1016/j.genhosppsych.2025.12.021 Full text Psychedelic Psychological support Psychotherapy

Stepping back into life: How Psychedelic Assisted Psychotherapy transforms the way of life of the terminally ill

General Hospital Psychiatry December 10, 2025 Justin Dwyer, Robert B. Johnston, Clare O'Callaghan et al. 3 citations

This qualitative study of how successful Psychedelic Assisted Psychotherapy (PAP) transforms the way of life of terminally ill subjects provides new knowledge for researchers and clinicians contemplating its use. Using an interpretive phenomenological approach (IPA) and interviews with subjects before and after PAP from a recent randomised control trial, we find that participants with extreme...

DOI: 10.1016/j.genhosppsych.2025.12.002

Psilocybin in late-life mental health: Addressing depression, loneliness, and existential anxiety

General Hospital Psychiatry December 9, 2025 Gerasimos Konstantinou, Joshua D. Rosenblat, Sarah Hales et al. 4 citations

The global demographic shift toward aging populations has intensified the need for innovative therapeutic interventions targeting late-life mental health conditions, notably depression, loneliness, and existential distress. Traditional pharmacological treatments often exhibit limited efficacy and poor tolerability in older patients, primarily due to age-related physiological changes and the...

DOI: 10.1016/j.genhosppsych.2025.12.005 Psilocybin Anxiety Psychological intervention Mental health +8

Psilocybin-assisted psychotherapy for depression and anxiety associated with life threatening illness: A phase 2b randomized controlled trial

General Hospital Psychiatry August 12, 2025 Margaret Ross, Ravi Iyer, M.l. Williams et al. 13 citations

Psilocybin-assisted psychotherapy appears safe and may offer durable relief from depression and anxiety in individuals with a life-threatening illness.

DOI: 10.1016/j.genhosppsych.2025.08.001 Psilocybin Anxiety Randomized controlled trial Psychotherapist +3

A dose of therapy with psilocybin - A meta-analysis of the relationship between the amount of therapy hours and treatment outcomes in psychedelic-assisted therapy

General Hospital Psychiatry August 5, 2025 Jennie Hultgren, Matthias H Hafsteinsson, Joel Gruneau Brulin 13 citations

Our findings did not support that the amount of therapy hours influence depressive outcomes in PAT. However, this interpretation should be made with caution due to small sample sizes, heterogeneity, and poor reporting of the therapeutic component across studies. Future research should apply greater methodological rigor and standardized reporting of therapy to clarify its role in PAT.

DOI: 10.1016/j.genhosppsych.2025.07.020 Psilocybin Meta-analysis Pharmacotherapy Psychotherapist +1

Effectiveness of mindfulness-based cognitive therapy via e-health on anxiety and depression in adults: A meta-analysis.

General Hospital Psychiatry July 24, 2025 Shizhen Wang, Mengru Wu, Jixiang Wei et al. 6 citations

Anxiety and depression are highly prevalent mental health disorders, imposing significant burdens on individuals and healthcare systems. Mindfulness-based cognitive therapy (MBCT) has demonstrated effectiveness in reducing these symptoms. Electronic health MBCT (eMBCT) offers a scalable alternative, but its efficacy in alleviating anxiety and depression in adults remains unclear. To examine the...

DOI: 10.1016/j.genhosppsych.2025.07.017 Full text Anxiety Depression E-health Meta-analysis +1

Should we skip the trip? Clinical implications of psychedelic-associated subjective effects and the potential role of non-hallucinogenic alternatives.

General Hospital Psychiatry July 3, 2025 Kush V. Bhatt, James D Asuncion, Al Alam et al. 4 citations

The resurgence of interest in classical psychedelics brings both promise and challenges to psychiatric care. Increasing evidence supports the therapeutic potential of psychedelics for a range of mental health conditions, and approval for clinical use appears inevitable. The psychedelic-associated acute subjective experience may mediate or enhance therapeutic outcomes, but also presents...

DOI: 10.1016/j.genhosppsych.2025.07.001 Full text Neuroplasticity Neural plasticity Psychedelics Hallucinogens +15

Patient-therapist relationship in psychedelic-assisted therapy: Implications for future real-world settings.

General Hospital Psychiatry June 6, 2025 Daniel Villiger 4 citations

The view that the use of serotonergic psychedelics in mental health care should always be psychotherapeutically embedded has recently been questioned. One argument against this model concerns the high costs it entails, which could limit the accessibility of psychedelic-assisted therapy (PAT)-a concern likely to gain traction if PAT is officially approved in the future. This paper analyzes the...

DOI: 10.1016/j.genhosppsych.2025.06.003 Full text Psychedelic-assisted therapy Psychedelic-assisted psychotherapy Clinical rapport Financial constraints +6

Key competencies for psychedelic treatment in real-world mental health care settings.

General Hospital Psychiatry 2025 Max Wolff, Hans Rutrecht, Gerhard Gründer et al. 9 citations

Psychedelic treatments are extending beyond research units and into hospitals, outpatient clinics, and community practices. Contrasting the constrained procedures of clinical trials with the realities of routine practice, this article outlines the competencies needed for safe, effective, and ethically sound psychedelic therapy in everyday mental health care. To accommodate mainstream adoption...

DOI: 10.1016/j.genhosppsych.2025.09.003 Full text

Effects of internet-based mindfulness interventions on anxiety and depression symptoms in cancer patients: A meta-analysis.

General Hospital Psychiatry 2025 Shizhen Wang, Wangjie Xia, Jian Zhang et al. 6 citations

This meta-analysis aimed to evaluate the effectiveness of internet-based mindfulness interventions on anxiety and depression symptoms in patients with cancer. Eight databases (Cochrane Library, PubMed, Embase, and PsycINFO CNKI, Wanfang, VIP, and CBM) were systematically searched from the inception of databases to August 2023 for randomized controlled trials (RCTs). Two independent reviewers...

DOI: 10.1016/j.genhosppsych.2025.02.022 Full text Anxiety Depression Cancer patients Meta-analysis

Set and setting in psilocybin-assisted therapy: A qualitative study of patients with cancer and depression.

General Hospital Psychiatry 2025 Yvan Beaussant, Elise C. Tarbi, Kabir Nigam et al. 3 citations

Psilocybin-assisted therapy (PAT) shows promise for cancer-related depression, yet little research has examined how therapeutic context shapes patient experiences. While set (mindset) and setting (environment) are considered central to psychedelic treatment, empirical evidence on their role in PAT acceptability remains limited. This study explores factors influencing the acceptability of PAT...

DOI: 10.1016/j.genhosppsych.2025.10.010 Full text Existential distress Major depressive disorder Cancer Psilocybin-assisted therapy

Effectiveness of meditation for fatigue management: Insight from a comprehensive systematic review and meta-analysis.

General Hospital Psychiatry August 1, 2024 Byung-Jin Park, Yu-Jin Choi, Jin-Seok Lee et al.

OBJECTIVE This systematic review and meta-analysis revealed the effectiveness of meditation in addressing fatigue, given its widespread use as a remedy for sleep disturbances and fatigue. METHOD We analyzed 29 randomized controlled trials from MEDLINE and the Cochrane Library, spanning from December 31, 2022. We conducted two metaanalyses using mean difference (MD) with normalized data and...

DOI: 10.1016/j.genhosppsych.2024.08.001

Blood pressure changes during ketamine infusion for the treatment of depression.

General Hospital Psychiatry 2024 Mina Ansari, Brian Pittman, Daniel S Tylee et al. 6 citations

This study aimed to examine blood pressure changes during ketamine infusion for depression and exploring the factors associated with these changes. This study is a retrospective chart-review of patients with depression undergoing ketamine infusion at Yale Psychiatry Hospital during a 7-year period. Blood pressure (BP) was recorded every 10 min during the infusion. Surges in systolic and...

DOI: 10.1016/j.genhosppsych.2024.07.001 Full text Esketamine Cardiovascular changes Severe hypertension Cardiovascular safety +4

N-methyl-d-aspartate (NMDA) receptor antagonists for treatment of catatonia in adults: Narrative review.

General Hospital Psychiatry 2024 Jeong Hoo Lee, Joji Suzuki 4 citations

While the majority of patients with catatonia fully respond to benzodiazepines or ECT, some have a partial or no response. Benzodiazepines may be contraindicated such as when delirium co-exists. This review discusses the utility of NMDA receptor antagonists as alternatives to benzodiazepines in the treatment of catatonia in adults. A PubMed search adhering to PRISMA guidelines was conducted for...

DOI: 10.1016/j.genhosppsych.2024.09.005 Full text Esketamine Amantadine Memantine Nmda receptor antagonists +4

A mindfulness meditation mobile app improves depression and anxiety in adults with sleep disturbance: Analysis from a randomized controlled trial

General Hospital Psychiatry September 11, 2021 Jennifer Huberty, Megan E. Puzia, Jeni Green et al. 76 citations

OBJECTIVE: The objective of this study was to 1) determine the effects of a meditation app on depression and anxiety in adults with sleep disturbance, and 2) explore the potential mediating effects of fatigue, daytime sleepiness, and pre-sleep arousal on the relationship between use of the meditation app and changes in depression and anxiety. METHODS: Participants were 239 adults with elevated...

DOI: 10.1016/j.genhosppsych.2021.09.004

Isolated nocturnal auditory hallucinations: a case report.

General Hospital Psychiatry 2011 Biswa Ranjan Mishra, Sukanto Sarkar, Sayali Mishra et al.

Sleep-related hallucinations (hypnagogic and hypnopompic) are transient and occur in normal individuals. Rarely, they are prominent and distressing and are associated with diverse conditions including narcolepsy. We report a case of prominent hypnopompic auditory hallucinations--which gradually became continuous and distressing with characteristics of schizophrenia-like hallucinations--that...

DOI: 10.1016/j.genhosppsych.2011.04.008 Full text

Psychotic symptoms in narcolepsy: phenomenology and a comparison with schizophrenia.

General Hospital Psychiatry 2009 Hal A Droogleever Fortuyn, G A Lappenschaar, Fokko J Nienhuis et al.

Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and contrast these with schizophrenia patients and healthy controls. We also compared the prevalence of formal...

DOI: 10.1016/j.genhosppsych.2008.12.002 Full text

Incidence and correlates of near-death experiences in a cardiac care unit

General Hospital Psychiatry July 1, 2003 Bruce Greyson 195 citations

Near-death experiences, unusual experiences during a close brush with death, may precipitate pervasive attitudinal and behavior changes. The incidence and psychological correlates of such experiences, and their association with proximity to death, are unclear. We conducted a 30-month survey to identify near-death experiences in a tertiary care center cardiac inpatient service. In a consecutive...

DOI: 10.1016/s0163-8343(03)00042-2

Mindfulness-based stress reduction and health-related quality of life in a heterogeneous patient population.

General Hospital Psychiatry July 1, 2001 Diane K. Reibel, Jeffrey M Greeson, George C. Brainard et al.

This study examined the effects of mindfulness-based stress reduction (MBSR) on health-related quality of life and physical and psychological symptomatology in a heterogeneous patient population. Patients (n=136) participated in an 8-week MBSR program and were required to practice 20 min of meditation daily. Pre- and post-intervention data were collected by using the Short-Form Health Survey...

DOI: 10.1016/s0163-8343(01)00149-9 Full text

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