Search Results (46)

Background and Clinical Significance: “Hikikomori”—a state of prolonged social withdrawal affecting an estimated 2% of Japan’s working-age population—is frequently associated with underlying anxiety disorders, such as gaze phobia, and contributes to the socio-economic burden known as the “8050 problem,” in which aging parents support their socially isolated adult children. While Morita therapy is effective for such conditions, nursing support has historically lacked a systematic theoretical framework. This case report presents a novel nursing model analyzing the transformation process from toraware (mental preoccupation) toward mokuteki-hon-i (purpose-driven action). It proposes the ‘side-by-side’ nursing approach as a potentially important element in supporting patient autonomy in similar clinical settings. Case Presentation: A man in his 20s, diagnosed with gaze phobia and experiencing long-term withdrawal following traumatic bullying, was referred to our specialized short-care program. After initial preparation through structured psychoeducation regarding Morita therapy principles (toraware, sei-no-yokubo, mokuteki-hon-i), he participated in a 14-month Morita therapy-based short-care program combining individual and group interventions. Initially, the patient exhibited severe social avoidance and was trapped in a cycle of seishin-kogo-sayo (psychic interaction). Nurses applied ‘Strategic Inattention to Symptoms’ (shojo-fumon) and provided specific role suggestions, such as serving as a secretary in group discussions, to elicit his sei-no-yokubo (desire for life). Through the reframing of his anxiety as a constructive drive, the patient shifted to a purpose-driven stance. Outcomes showed improved self-adjustment skills in public spaces and successful social reintegration through sustained part-time employment. Conclusions: Nursing care characterized by ‘intentional non-intervention’—which involves waiting in a ‘side-by-side’ manner within a minimally structured environment—may contribute to fostering patient autonomy in similar clinical contexts. This ‘experience-oriented’ approach appeared to elicit inner strengths and support self-regulation in this case, warranting further investigation in multi-case designs. The relative contributions of individual nursing support and group therapeutic milieu cannot be disentangled in a single-case design. Full article

In Genesis Jacob dreams of a ladder, its base rooted solidly on the ground, its top reaching toward the heavens. On it, angels ascend and descend, moving heavenward from earth, and earthward from heaven. Jacob wakes from his dream, exclaiming, “God is in this place, and I didn’t know!” The imagery of Jacob’s ladder offers a vivid illustration in spiritual terms of the capacity of the human psyche to move between different dimensions of being and levels of awareness and to be transformed by doing so. In psychological terms, it serves as a useful entry point into an examination of the transformative potential of a psychoanalytic approach to spiritual care. Drawing upon Hans Loewald’s formulation of therapeutic action, further developed by contemporary relational theorists, this essay argues that psychic transformation entails a dynamic interplay of unconscious and conscious process, in which inarticulate experience is re-animated within the structures of thought and language, contributing to renewed psychic vitality. Mediated by transference, the analytic relationship facilitates this transformation, attending to unconscious experience, ideally without imposing premature narrative closure. This essay contributes to an interdisciplinary dialogue between clinical psychoanalysis and religious studies by highlighting Loewald’s theorizing about “what makes human life human” and its potential value in the treatment and care of those suffering a crisis of the spirit. Full article

Pharmacological chaperones (PCs)—small molecules that normalize the 3D structure of mutant protein molecules—are promising substances for pharmacological treatment of grave hereditary pathologies. In this study, possible chaperone-like effects of the Fe(II) with tris(1-pyrasolyl)methane complex, [Fe(TPM)₂]Cl₂, on the mutant 447R form of mouse tryptophan hydroxylase 2 (TPH2) in vitro and in vivo were investigated. The experiments were carried out on Balb/c mice homozygous for the mutant TPH2. This complex in concentrations of 0.01, 0.05 and 0.1 mM markedly increased the temperature (T₅₀) and free energy (ΔG) of the mutant TPH2 thermal denaturation in vitro. Seven intramuscular administrations of 30 and 60 mg/kg of [Fe(TPM)₂]Cl₂ markedly increased the TPH2 activity in the midbrain of Balb/c mice. This increase in the TPH2 activity was not accompanied with an increase in the Tph2 gene mRNA and TPH2 protein levels. It is the first demonstration of chaperone-like activity of [Fe(TPM)₂]Cl₂. This complex is a promising chemical for correction of genetic alterations in TPH2 and the associated hereditary psychic disorders. Full article

This article explores Mihail Aslan’s volume of poetry Late Geometries, Rejected through the prism of an in-depth psychoanalytic reading. The text highlights how the poetic work constitutes an expression of deep psychic processes, centered around the concepts of early trauma, narcissistic deficit, and failure of the primordial environment. Through theories by authors such as Winnicott, Anzieu, Green, and Kristeva, the article reveals how Aslan’s creation functions as a transitional space, in which a complex dialectic takes place between Eros and Thanatos, between the constitution of the self and its waste. Writing thus becomes an act of psychic survival, a way to metabolize the traumatic experience and to reconstruct an inner geometry, albeit “late” and “rejected”. Full article

Background/Objectives: Esketamine-related dissociation is a transient, pharmacologically induced altered state that differs from the trait-like pathological dissociation typically observed in trauma-related conditions. While most studies have quantified these effects using the Clinician-Administered Dissociative States Scale (CADSS), patients’ subjective phenomenology and meaning-making remain underexplored. This qualitative exploratory study investigated how patients narrate, interpret, and integrate dissociative experiences occurring during intranasal esketamine treatment for treatment-resistant depression (TRD). Methods: We conducted semi-structured interviews with 36 adults with TRD who were receiving intranasal esketamine in outpatient settings in Northern Italy (2022–2024). Interviews focused on the most salient dissociative experiences during treatment. Transcripts were anonymized and analyzed using inductive thematic analysis. Two researchers coded the data independently; discrepancies were resolved by consensus, and recruitment continued until thematic saturation was reached. Results: Four experiential domains emerged: sensory alteration and perceptual flow (10/36, 27.8%), time suspension and chronological drift (21/36, 58.3%), body and space alteration (20/36, 55.6%), and psychic distance from suffering (30/36, 83.3%). While a minority described transient distress or loss of control, most narratives framed dissociation as neutral or subjectively meaningful, often associated with a temporary reduction in ruminative self-focus and depressive distress. Conclusions: A narrative, phenomenological lens complements quantitative research by clarifying what esketamine-induced dissociation feels like to patients and how it is appraised in context. The findings do not imply a causal or mediating role in antidepressant efficacy. Rather, they suggest that dissociation functions as a transitional subjective state, the clinical relevance of which depends on anticipation, framing, monitoring, and integration. These results support the use of structured psychoeducation, in-session support, and post-session integration within real-world esketamine programs. Full article

This article re-interprets V. S. Naipaul’s “Tell Me Who to Kill” from In a Free State (1971) through a Heideggerian lens, focusing on the ‘groundlessness’ of existence and the dialectics of ‘danger’ that structure the unnamed narrator’s life within colonial ‘modernity’. Using Hiedegger’s phenomenology as a rhetorical hermeneutic, it traces how ordinary existential structures—fear, anxiety, boredom, curiosity, idle talk, and ambiguity—surface in the narrator’s and other characters’ comportments and speech. In Heidegger’s sense, these moods do not simply describe psychological states but reveal the conditions of Dasein’s being-in-the-world and the ontological disclosures of a being unhomed by empire. By situating Heidegger’s concepts of Dasein, thrownness, and fallenness within Naipaul’s world of migration, labour, and racial precarity, the paper reveals how metaphysical homelessness becomes historically tangible. The narrator’s obsessive drive for success, his failed fraternal duty, and his descent into estrangement dramatize a colonial subjectivity torn between aspiration and abjection. In reframing Heidegger through the postcolonial experience, the article both deprovincializes European existentialism and reclaims phenomenology as a site for interrogating the psychic economies of empire. Ultimately, the novella becomes a poetics of nihilism—where the search for authenticity collapses under the weight of displacement. Full article

In recent years, Norwegian cultural production has increasingly foregrounded the experiences of sailors serving aboard merchant vessels allied with the British during the Second World War. These men endured not only physical injuries from submarine and aerial attacks, but also profound psychic trauma, often manifesting in post-war alcoholism and depression. However, the war at sea also left indelible marks on women’s bodies. This article examines Vigdis Stokkelien’s trilogy on Gro—Lille-Gibraltar (Little Gibraltar, 1972), Båten under solseilet (The boat under the sun sail, 1982), and Stjerneleden (The star joint, 1984)—to explore how emotions as fear, shame and pain circulate between different individuals and groups during the war and in war memories. Drawing on affect theory, this reading of Stokkelien’s novels demonstrates how what happened at sea marked Norwegian bodies and national identity for a long time after the war. Full article

This article defines estranged sorrow as a category of trauma that cannot be grieved because it was never consciously experienced. As a domain of grief prevented from moving into conscious awareness, estranged sorrow becomes an underlying, chronic source of unspeakable sorrow that diminishes the ability to experience the full range of psychic reality or potentiality. Estranged sorrow encompasses not having developmental psychological needs met, the absence of community, the presence of structural injustice, and the dwindling access to the numinous. Accounting for estranged sorrow beneath a variety of pathologized symptoms shows how the absence of soul and imagination accounts for an addiction to numbing as well as the epidemic of loneliness through a loss of self and social modes of awareness—and thus relationality. I then look to the importance of imaginal revisioning, part of the methodology of archetypal psychology, to better understand and begin working through trauma unearthed by exploring estranged sorrow. The process of revisioning involves the soul-work of personifying the world, seeing through the literal ideas that limit our access to psychic reality, enduring the feelings that something is wrong, and returning to an expanded psychic reality. This article concludes by reflecting on this process in the light of myth. Full article

Psychic suffering is typical of the human condition and involves multideterminant factors in its origin, with significant influence from affective–relational–economic issues, invariably marked by negative and positive experiences. Objective: The objective of this study is to describe the process of construction and content validation of a set of nursing actions to integrate a mobile educational technology to assist individuals in psychic distress in primary health care. Methods: This was a methodological study in four stages: scope review, qualitative research, elaboration of a set of nursing actions and content validation. It was carried out from December/2022 to December/2023, with 16 Brazilian specialists, a minimum Content Validity Index of 80% and Cronbach’s Alpha (α). Results: Six sets of actions were elaborated and evaluated: nursing actions in the initial assessment of the individual in psychic distress (99% α 0.47); nursing actions towards individuals in psychic distress with complaints associated with Depressive Disorder (93.4% α 0.84); nursing actions towards individuals in psychic distress with complaints associated with Anxiety Disorder (95.4% α 0.88); nursing actions towards individuals in psychic distress with Suicidal Ideation (96.3% α 0.71); nursing actions towards individuals in psychic distress resulting from the use of psychoactive substances (99.6% α 0.77) and; nursing actions towards individuals in psychic distress as a result of grief situations (98.6% α 0.28). Conclusions: The set of actions proved to be validated and to have acceptable reliability, thus contributing to supporting the development of educational technology. The conclusions of this research highlight the possibility for nurses to conduct nursing actions in the care of people in psychic distress, in a non-specialized context. In addition, this is a resource to improve the routine mental health care of nurses who work in primary health care. Full article

Objectives: We aimed to examine the relationship of Dopamine transporter (DAT) and vesicular monoamine transporter (VMAT-2) gene and protein levels with psychic experiences and other clinical parameters in individuals with Methamphetamine Use Disorder (MUD). Methods: This study included 50 males diagnosed with MUD and 50 males as a smoking control (SC) and nonsmoking control (NSC). Community Assessment of Psychic Experiences (CAPE) was administered to patients and controls; Addiction Profile Index, Treatment Motivation Questionnaire, and Substance Craving Scale were administered only to the patient group. DAT and VMAT2 gene and protein levels were determined in blood obtained from the controls and patient groups. Results: CAPE positive, depressive, total, and distress scores were significantly higher in the patient group. DAT protein level and VMAT2 gene and protein levels were lower in the patient group compared to the controls. The DAT gene expression level was higher in the patient group compared to the controls. There was no correlation between any clinical variables and expression levels. A low VMAT2 gene expression level could diagnose MUD with a 5% probability when NSCs were used as a reference. A high DAT gene expression level could diagnose tobacco use disorder (TUD) with a 99.9% probability when NSCs were used as a reference. Conclusions: The patient group showed more psychic experiences than healthy people. The low expression of the VMAT2 gene was identified as a predictor of MUD, while the high expression of the DAT gene was predictive of TUD. Full article

The aim of this study is to identify autism spectrum disorder (ASD) and attention-deficit–hyperactivity disorder (ADHD) traits in adolescents who experience psychotic-like experiences (PLEs), often ignored in clinical practice but widely prevalent in the general population. A total of 57 adolescents and young adults (aged between 16 and 24 years old) were recruited consecutively in the outpatient services. A total of 37 were females (64.9%), 18 were males (31.6%), and two participants (3.5%) were non-binary or gender non-conforming, with a mean age at referral of 18.26 ± 2.06. To investigate these symptoms, three sets of standardized questionnaires were used, as follows: the Autism Spectrum Quotient–short form (AQ-10), the Community Assessment of Psychic Experiences (CAPE-42), and the Adult ADHD Self-Report Scale (ASRS). We found significant associations between the ASRS and AQ-10 total scores and all CAPE scales. The model which explained the highest variance was CAPE Score’s Total Frequency score (p < 0.001). Our findings underline the importance of investigating the presence of subthreshold ASD and ADHD symptoms in clinical populations, particularly in the period of adolescence and young adulthood, to promptly identify the presence of PLEs and, thus, prevent the onset of a frank psychotic disorder, particularly in the presence of a comorbid psychopathological condition, leading to better diagnosis and treatment for individuals with two or more of these conditions. Full article

Guyana’s colonial past has left a trail of economic instability, racial polarization, and physical and mental trauma. Despite the progress made since Guyana’s independence in 1966, the remnants of this colonial past continue to shape present-day Guyana. As a result, violence and trauma continue to impact the mental health of the population. This is manifest in endemic problems of domestic violence and racialized social divisions which have created the conditions for rates of suicide which are amongst the highest in the world. The formal mental health provision which exists in Guyana is based primarily on an individualized and largely biomedical model of care. Despite valuable attempts to develop this provision, the difficulty of physically accessing this for some people and the stigma which surround this means that the capacity of this system to address the serious problems which exist is limited. It is also the case that in times of emotional and psychic distress, and in the context of Guyana being a very religious country, many people turn to traditional supernatural healers and remedies for support. In this paper, we discuss what is known as “Obeah”, noting that while this is widely practiced, it remains something of a taboo subject in Guyana. We consider the reasons why these practices and beliefs continue to be influential. However, what neither these biomedical or supernatural perceptions of mental health are able to address is the sociogenic nature of Guyana’s mental health issues, which we argue emerges out of the historic trauma of Guyana’s experience of colonialism and the violence which it engendered. We argue that profound forms of mental distress which exist in Guyana call for an integrative and holistic practice model that contextualizes these problems through a sociogenic lens. Social workers, working collaboratively with other health-related professions, can occupy a critical role in integrating these different conceptions through developing a rights-based model of mental health where the causes of mental ill-health are understood as socially determined. Full article

Cocaine is one of the most consumed illegal drugs among (young) adults in the European Union and it exerts various acute and chronic negative effects on psychical and physical health. The central mechanism through which cocaine initially leads to improved performance, followed by addictive behavior, has already been intensively studied and includes effects on the homeostasis of the neurotransmitters dopamine, partly mediated via nicotinic acetylcholine receptors, and serotonin. However, effects on the peripheral nervous system, including the enteric nervous system, are much less understood, though a correlation between cocaine consumption and gastrointestinal symptoms has been reported. The aim of the present study was to gain more information on the effects of cocaine on enteric neuronal functions and the underlying mechanisms. For this purpose, functional experiments using an organ bath, Ussing chamber and neuroimaging techniques were conducted on gastrointestinal tissues from guinea pigs. Key results obtained are that cocaine (1) exhibits a stimulating, non-neuronal effect on gastric antrum motility, (2) acutely (but not chronically) diminishes responses of primary cultured enteric neurons to nicotinic and serotonergic stimulation and (3) reversibly attenuates neuronal-mediated intestinal mucosal secretion. It can be concluded that cocaine, among its central effects, also alters enteric neuronal functions, providing potential explanations for the coexistence of cocaine abuse and gastrointestinal complaints. Full article

(1) Background: although studies of cognitive functions are still limited in borderline personality disorder (BPD), the initial evidence suggested that BPD patients have deficits of executive functions and social cognition. In addition, patients who report physical and psychic traumatic experiences in childhood and adolescence show considerable neurocognitive impairment and severe BPD symptoms. The present study has a twofold aim: (1) to evaluate the differences in neurocognitive performances between BPD patients and healthy controls and (2) to verify in the BPD patients group whether neurocognitive deficits have the role of mediating the effect of early traumas on BPD psychopathology. (2) Methods: 69 subjects were enrolled: 38 outpatients with a diagnosis of BPD (DSM-5) and 31 healthy controls. BPD patients were tested with the Borderline Personality Disorder Severity Index (BPDSI), and the Childhood Trauma Questionnaire–Short Form (CTQ-SF). All subjects were evaluated with the Iowa Gambling task (IGT), the Berg card sorting test (BCST), the Tower of London task (ToL), and the Reading-the-mind-in-the-eyes-test (RMET). Statistical analysis was performed with the analysis of variance to compare the cognitive performances between BPD patients and controls. A mediation analysis was conducted with the Sobel Test in the BPD patients group. The significance level was p ≤ 0.05. (3) Results: significant differences between the two groups were found for several parameters of all the cognitive tests examined: BCST, IGT, ToL, and RMET. Mediation analysis with the Sobel test demonstrated that the percentage of correct answers in the BCST (BCSTc) and the RMET score significantly mediated the relation between the CTQ total score and BPDSI total score. (4) Conclusions: BPD patients showed an impairment of the following executive functions: set shifting, decision making, planning and problem solving, and social cognition abilities, in comparison with controls. Our results suggested that the effect of early trauma on BPD psychopathology was mediated by a deficit in two cognitive domains: cognitive flexibility and social cognition. Full article

Spinal Cord Injury (SCI) is a common neurological disorder with devastating psychical and psychosocial sequelae. The majority of patients after SCI suffer from permanent disability caused by motor dysfunction, impaired sensation, neuropathic pain, spasticity as well as urinary complications, and a small number of patients experience a complete recovery. Current standard treatment modalities of the SCI aim to prevent secondary injury and provide limited recovery of lost neurological functions. Stem Cell Therapy (SCT) represents an emerging treatment approach using the differentiation, paracrine, and self-renewal capabilities of stem cells to regenerate the injured spinal cord. To date, multipotent stem cells including mesenchymal stem cells (MSCs), neural stem cells (NSCs), and hematopoietic stem cells (HSCs) represent the most investigated types of stem cells for the treatment of SCI in preclinical and clinical studies. The microenvironment of SCI has a significant impact on the survival, proliferation, and differentiation of transplanted stem cells. Therefore, a deep understanding of the pathophysiology of SCI and molecular mechanisms through which stem cells act may help improve the treatment efficacy of SCT and find new therapeutic approaches such as stem-cell-derived exosomes, gene-modified stem cells, scaffolds, and nanomaterials. In this literature review, the pathogenesis of SCI and molecular mechanisms of action of multipotent stem cells including MSCs, NSCs, and HSCs are comprehensively described. Moreover, the clinical efficacy of multipotent stem cells in SCI treatment, an optimal protocol of stem cell administration, and recent therapeutic approaches based on or combined with SCT are also discussed. Full article