Search Results (930)

Background: The illegal status of recreational cannabis (RC) is often considered a barrier to its use. RC was partially legalized in Germany in 2024. This study investigated whether attitudes towards cannabis were different in patients surveyed after recreational cannabis legalization (RCL), compared with patients surveyed before RCL. Method: In 2022 (pre-RCL) and 2024/2025 (post-RCL), patients without psychosis and without substance use disorders from in-patient and day clinic wards of a psychiatric university hospital were interviewed using a standardized questionnaire. Results: Included were n = 143 patients pre-RCL and n = 117 post-RCL, with 84% presenting with affective disorders. Only 11.2% in the pre-RCL group, and 1.7% in the post-RCL group indicated the illegal status of RC as the main reason for cannabis abstinence. Attitudes towards cannabis with regard to health concerns, social distance, general rejection of (illicit) drugs, effects of drug education, or observation of negative consequences in others were not statistically significantly different between groups. There was a marked and statistically significant reduction in fear of being investigated by the police because of RC consumption. The suggestion to buy cannabis for personal use in specialized shops was completely rejected by 58.7% of the pre-RCL and by 71.8% of the post-RCL group. Conclusions: Compared with pre-RCL data, concerns about negative legal consequences of RC use were lower during the first year post-RCL, but readiness to legally obtain recreational cannabis was not increased. There were no indications that other attitudes about cannabis were affected in the short term. Full article

This article analyzes the laboratory discourse in Soviet society during the first third of the twentieth century through the lens of tékhnē—the ancient fusion of making and knowing—arguing that the laboratory became a key site for redefining artistic practice as a form of knowledge production. Drawing on the institutional critique of the laboratory (Bruno Latour), the author raises the question of the potential for mutual influence between different types of laboratories established in the fields of art, technical sciences, and production. The mechanisms of a laboratory’s influence on society, as identified by Latour, allow for a new interpretation of the phenomenology of the All-Russian Theatre Society and its significant internal divisions. The history of the emergence and defeat of the Laboratory of Mass Psychology at the All-Russian Theatre Society (ARTS) in the 1920s–1930s is reconstructed on the basis of archival materials from RGALI (fund 970). Meeting minutes and documents from 1929 to 1932 reveal the main modes of the anthropology of the “laboratory genre” within the ARTS system (1920s–1980s). These are examined within the general experimental context of the era: the laboratory boom of the 1920s–1930s reshaped the boundaries between the natural sciences and the humanities. The second mode is the human experience of being on the threshold between life and death—a transgressive state. The third mode is the laboratory as a site for new forms of labor and technology. Within the laboratory’s work, psychotechnics acquired particular significance, reaching its culmination in 1931–1932. This period, marked by an intense flurry of events and new laboratory practices of psychological influence, was rightly called a “psychosis of activities” by the participants of the ARTS laboratory themselves. Full article

Background: Substance Use Disorder (SUD) is frequently associated with psychiatric comorbidity, including psychotic symptoms, impulsivity and neurodevelopmental traits. The influence of age and duration of substance use on these clinical characteristics and on treatment retention remains insufficiently understood. Objectives: To examine the influence between age, duration of substance use, clinical presentation, patterns of violence, and treatment retention in individuals with SUD. Methods: A prospective 6-month cohort study was conducted at the Alcoholism Treatment Unit of the CAUSA Hospital Complex in Salamanca, Spain. A total of 264 patients with SUD were classified into two groups: prolonged substance use (≥55 years of age or ≥25 years of substance use; n = 127) and shorter substance use trajectories (<55 years and <25 years of substance use; n = 137). Participants completed structured clinical interviews and validated measures of quality of life, impulsivity, autistic traits, addiction severity, psychotic symptoms and violence. Non-parametric analyses were applied (α = 0.05; 95% CI). Results: Younger participants showed a significantly higher prevalence of auditory and visual hallucinations and persecutory delusions at baseline. During follow-up, both groups exhibited a reduction in physical aggression while driving and an increase in insults and verbal threats. No significant differences were observed in recent uncontrolled violence. Positive screening results for ADHD, autistic traits and impulsivity were not associated with treatment retention. Lower baseline physical functioning was associated with reduced completion of the 6-month follow-up assessment. Conclusions: Age and duration of substance use were associated with differences in the clinical presentation of SUD. Younger individuals exhibited a greater burden of psychotic symptoms and violence-related behaviours, whereas poorer physical functioning was associated with lower follow-up retention among individuals with prolonged substance use histories. These findings support the importance of age-sensitive assessment and management strategies in patients with SUD. Full article

Narrative psychotherapy focuses on jointly discussing life stories with patients to promote shifts in sense of self and narrative identity. Narrative approaches have roots in constructivism which requires various elements or cognitive processes necessary for meaning making, such as the discussion of thoughts and feelings, how thoughts and feeling change over time, and how the patient’s construction of meaning contributes to their sense of self and place in the world. Narrative psychotherapy may have unique elements that promote recovery for people with psychosis. For instance, narrative approaches may help to integrate narratives that are fragmented or focused on illness identity, though the research is limited. The current study is a narrative review that aims to (1) discuss current theoretical and research findings related to narratives and narrative identity in people with psychosis; (2) identify and describe psychotherapy approaches that focus on narratives. We summarize recent findings that highlight positive outcomes for people experiencing psychosis, and how people move towards more integrated and complex narratives. We found a range of therapeutic approaches that focus on narratives including metacognitive therapy (i.e., metacognitive reflection and insight therapy), trauma-based psychotherapy (i.e., trauma-focused cognitive-behavioral therapy for psychosis and narrative enhancement therapy), treatment focused on self-stigma or illness identity (i.e., narrative enhancement and cognitive therapy and self-concept and engagement and life), and art and creative therapies. We discuss interpretation of findings and their implication for mechanisms of change. Full article

Background: While the consumer experience of psychosis has received significant attention in Western research, a substantial gap exists regarding the experiences of women in the Kingdom of Saudi Arabia (KSA). In this context, religious, cultural, familial, and gender-specific factors uniquely shape the experience of psychosis, help-seeking behaviors, and recovery. This study aimed to explore the lived experiences of Saudi women with psychosis across three phases: first-episode onset, hospitalization or follow-up, and community living after discharge. Methods: This hermeneutic phenomenological study, guided by van Manen’s methodology, employed all six lifeworld existentials: lived space, lived body, lived time, lived self-other, lived thing, and lived cyborg. Semi-structured interviews were conducted with 21 women diagnosed with psychosis at two hospitals in Riyadh, KSA. Data collection included 13 audio-recorded interviews and eight documented via field notes, supplemented by creative methods such as drawings, poems, and written texts analyzed using van Manen’s vocative method. All Arabic data were professionally translated and verified for accuracy. Results: Three overarching themes emerged. First, women’s lived experiences of first-episode psychosis highlighted the process of understanding causes and developing insight during onset. Second, experiences during admission and follow-up revealed the impact of clinical encounters, nursing care, and the critical need for therapeutic healing spaces. Third, living with psychosis in the community emphasized the complexities of medication adherence, family dynamics, and the pursuit of recovery through education, employment, and religious practice. Conclusions: The participants articulated user-based recovery perspectives, including empowerment, shared decision-making, and hope, which contrasted sharply with the service-based approaches they received. Culturally specific stressors and pervasive stigma shaped every phase of their journey. To the authors’ knowledge, no prior study has examined this population using a hermeneutic phenomenological framework; these findings provide a women-focused, culturally situated evidence base for developing gender-specific recovery models and enhanced discharge planning within the KSA mental health system. Full article

Sleep disturbances are among the most prevalent and clinically significant features observed across the psychosis spectrum, ranging from clinical high-risk (CHR) mental states to first-episode psychosis (FEP) and chronic schizophrenia. Far from being merely secondary phenomena, sleep difficulties—including insomnia, circadian rhythm disruption, altered sleep architecture, hypersomnia, and nightmare disorder—are increasingly acknowledged as transdiagnostic risk factors that may contribute to symptom severity, cognitive impairment, functional decline, and heightened suicidal risk. This narrative review consolidates current evidence on the epidemiology and neurobiological foundations of sleep disturbances in the psychosis spectrum and critically evaluates available non-pharmacological and digital interventions aimed at targeting sleep as a modifiable clinical outcome. We posit that sleep represents a critical, potentially modifiable intervention target within psychosis and that integrating sleep-focused care into standard clinical pathways may substantially enhance clinical, functional, and safety outcomes throughout the illness spectrum, pending replication in adequately powered randomized controlled trials. Full article

Background/Objectives: Interest in mental health research from the Arab world has grown in recent years, yet evidence on effective care remains uneven across subregions. The unique landscape of the Gulf countries underscores the need for culturally responsive psychosocial interventions for these vulnerable populations. This scoping review aimed to map psychosocial interventions for psychosis and schizophrenia that have been evaluated in Gulf countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Methods: Following scoping review methodology and PRISMA-ScR reporting guidance, we conducted systematic searches across five databases (APA PsycINFO, PubMed, Embase, Scopus, and Web of Science). Records were screened using predefined eligibility criteria and grouped thematically based on intervention type. Results: Ten studies met the inclusion criteria, including six English-language studies and four Arabic-language studies. Studies were conducted in Saudi Arabia, Kuwait, Oman, and the United Arab Emirates, with no eligible studies found from Bahrain or Qatar. Intervention types clustered into four categories: psychosocial rehabilitation platforms, social and functional skills interventions, caregiver-focused psychosocial interventions, and transdiagnostic studies. Outcomes, cultural adaptation processes, and methodological reporting varied considerably across studies. Conclusions: The findings highlight gaps in intervention development, evaluation standards, and the reporting of cultural adaptation, which may inform culturally responsive service planning for people with psychosis and schizophrenia across the region. Future studies should use standardized concepts, validated outcome measures, and clearer reporting of cultural adaptation processes to support direct comparisons and improve treatment evaluation across Gulf countries. Full article

Psychoactive substance use is a frequent cause of Emergency Department (ED) presentations among young adults and often involves polysubstance use. We conducted a retrospective descriptive analysis of 76 presentations involving acute recreational drug toxicity in 2024 at a Greek tertiary hospital participating in the Euro-DEN network. The mean age was 30 years, and 61% were male. Cannabis was the most frequently reported substance, followed by cocaine, benzodiazepines and antidepressants. Common clinical features included anxiety, agitation, psychosis, vomiting and tachycardia. Hospital admission was required in 24% of cases and 4% required ICU care, with no fatalities recorded. Substance identification was based on clinical documentation and patient self-report without toxicological confirmation. Full article

Schizophrenia remains a debilitating global health challenge where pharmacologic treatment has been stagnant for over seventy years, relying almost exclusively on the blockade of dopamine receptors. While this mechanism controls positive psychosis, it frequently fails to address negative symptoms or cognitive impairment and carries a significant burden of metabolic and motor adverse effects. This review evaluates the scientific and clinical validation of xanomeline–trospium (Cobenfy^®; investigational name KarXT), the first approved antipsychotic with a completely non-dopaminergic mechanism of action. We synthesize data ranging from the unique structural biology of the bitopic M1/M4 muscarinic receptor agonist xanomeline to the pharmacokinetic innovation of using the peripheral antagonist trospium chloride to mitigate systemic toxicity. Comprehensive analyses of the EMERGENT clinical trial program demonstrate that this combination significantly reduces heterogeneous schizophrenia symptoms with a safety profile distinct from current standards of care, specifically avoiding weight gain and extrapyramidal movement disorders. Furthermore, we contrast this success with the recent failures of other novel mechanisms and explore the potential for precision medicine through the identification of muscarinic receptor deficit biotypes. We conclude that M1/M4 muscarinic receptor agonism represents an important advance toward circuit-based therapeutics that may help overcome some of the limitations inherent to dopamine-centered pharmacotherapy. Full article

Fear is a transdiagnostic construct implicated in multiple psychiatric disorders, reflecting a partial dissociation between clinical phenotypes and underlying neurobiological mechanisms. Converging evidence suggests that aberrant fear processing plays a central role in cognitive and psychopathological models of psychosis. In this narrative review, we synthesize evidence on the neurobiological mechanisms of aberrant fear modulation in schizophrenia from a translational perspective, integrating findings from neuroimaging, preclinical models, pharmacological interventions, and psychotherapy. Schizophrenia is characterized by aberrant emotional processing and inappropriate neural responses to stimuli with reduced or absent objective salience, reflecting impaired discrimination of relevant environmental information. At the system level, evidence implicates dysregulation of cortico-limbic and salience-processing networks in altered fear learning, threat appraisal, and emotional prediction. Neurochemical findings indicate that dopamine–glutamate dysregulation and associated intracellular signaling pathways act as upstream modulatory mechanisms contributing to these network-level abnormalities. Therapeutic interventions, including antipsychotic drugs and psychotherapeutic approaches, partially modulate these systems, although effects remain heterogeneous. Overall, the evidence supports a hierarchical model in which aberrant fear processing in schizophrenia arises from disrupted salience attribution and impaired integration across cognitive, affective, and neurobiological levels. This intermediate dysfunction links molecular alterations to large-scale network disturbances and clinical symptom expression, providing a framework for more mechanism-based therapeutic strategies. Full article

Religious psychopathology as a field lies at the intersection of psychiatry, theology, and culture. It addresses scientific discoveries and questions relating to the manifestation of mental health disorders that are expressed through religious content, ideation, and/or behavior. Religious psychopathology, being a multifaceted phenomenon, challenges clinicians, researchers, and religious leaders because it is non-trivial to distinguish between culturally normative religious experiences and pathological symptoms. The present integrative narrative review examines historical perspectives, diagnostic challenges, clinical manifestations, cultural considerations, therapeutic interventions, neurobiological models, ethical issues, and future directions in the field of religious psychopathology. It focuses primarily on literature from 2013 to 2025, while also incorporating selected foundational historical, theoretical, and clinical sources necessary for conceptual clarification. A special emphasis is placed on culturally informed and interdisciplinary approaches. Particular focus is given to approaches that respect spiritual frameworks while concurrently promoting evidence-based mental health care. Full article

Wearable inertial sensing has considerable potential for process-level analysis of upper-limb function, but further evidence is needed to understand how it can be applied within ecologically structured immersive virtual reality (VR) tasks. Most VR-based functional assessments rely primarily on outcome-level indicators, such as task completion time, success rate, or error count, which may not fully capture how a task is executed. This exploratory study investigated whether wearable IMU signals collected during an immersive VR sushi-making task could support binary detection of a core upper-limb manipulation phase and provide additional information about task execution beyond global performance outcomes. A total of 45 participants contributed usable motion recordings for this study, with five Xsens DOT sensors placed on the hands, forearms, and waist. Three signal modalities were analysed, including acceleration (ACC), gyroscope angular velocity (GYR), and Euler angles. The downstream recognition problem was formulated as a binary classification task (Placing vs. Non-Placing), and a self-supervised learning (SSL) pretrain–fine-tune strategy was evaluated against conventional machine learning and from-scratch deep learning baselines using five subject-wise validation splits. The strongest overall performance was achieved with hand-mounted accelerometer signals, with LeftHand–ACC achieving a Macro-F1 of $0.712\pm 0.128$ and RightHand–ACC achieving $0.679\pm 0.118$. Under both hand-ACC settings, SSL fine-tuning showed higher mean Macro-F1 than the Balanced Random Forest baseline and the same deep architecture trained from scratch. Recognition performance varied substantially across sensor locations, signal modalities, and task segments, with distal upper-limb sensors generally outperforming waist-based configurations. Cross-age analyses further showed that within-cohort and cross-cohort performance did not fully align, indicating sensitivity to age-related distribution shift. Beyond classification, Log Dimensionless Jerk (LDLJ) derived from the Placing action showed a significant positive association with Cognitron motor control time cost ($r=0.636$, $p<0.001$). These findings suggest that wearable IMU sensing can provide preliminary process-level information during immersive VR functional tasks, including task-phase detection, sensing-configuration comparison, cross-cohort generalisation assessment, and exploratory motion-quality analysis. The results should be interpreted as evidence of feasibility rather than as a mature biomechanical or clinical assessment model. Full article

Perinatal mental illness affects up to 20% of new mothers worldwide, yet despite a growing research interest over the past decade, the etiology is still not fully understood, and clinical treatment guidelines remain inconsistent across countries and services. In this review, recent findings on neurobiological processes and evolutionary mechanisms, as they occur during the menstrual cycle, pregnancy, birth, postpartum and breastfeeding, are discussed. The intention is to raise awareness of physiological changes in pregnancy that might be relevant to the differential diagnosis and clinical treatment of perinatal psychiatric disorders such as depression, anxiety, PTSD after childbirth, bipolar relapse, postpartum psychosis, obsessive-compulsive symptoms, substance-use disorders, and suicidality. Areas addressed include the activities of the immune system, thyroid gland, cortisol, sleep and individual sensitivity to ovarian hormone fluctuations. Evolutionary biological mechanisms intended to sustain pregnancy and to ensure the survival of the newborn are assumed to have potent effects on the maternal brain. These non-pathological adaptations could provide grounds for a better understanding of risk factors and the etiology of perinatal mental illness. Full article

Nature-based interventions (NBIs) are increasingly used in mental health services, but their effectiveness in people with psychiatric disorders, and how these individuals experience them, remains unclear. This review synthesised quantitative and qualitative evidence on NBIs in psychiatric populations. Eligible studies evaluated outdoor NBIs against controlled comparators, excluding neurodevelopmental/degenerative conditions and indoor or virtual interventions. Quantitative outcomes were synthesised using random-effects meta-analysis; qualitative data were analysed using thematic synthesis. Twenty-eight studies were included, mostly involving people with diagnoses of schizophrenia or depression. NBIs were associated with greater improvements in clinical symptoms than controlled comparators (pooled effect size 0.71 [95% CI 0.29–1.12]; p = 0.0009), with moderate heterogeneity (I² = 48.6%). The qualitative synthesis identified five themes: Being in Nature, Personal Growth, Psychological Wellbeing, Social Relationships, and Physical Benefits. Participants reported reduced stress, improved mood and coping, strengthened identity, enhanced social connection, and increased energy. NBIs, particularly horticultural programmes and guided outdoor activities, may offer promising recovery-oriented adjuncts to psychiatric care. The next step is to build a translational evidence base by harmonising recovery-relevant outcomes and developing pragmatic, scalable models of delivery that can be embedded within routine mental health services, informed by mixed methods evaluation. Full article

Background/Objectives: Vitamin D is a nutrient-related secosteroid system with endocrine, paracrine, immunological, and neurodevelopmental actions relevant to nutritional psychiatry. Psychiatric research has often treated vitamin D either as a cross-sectional correlate of depression or as a non-specific supplement expected to act across heterogeneous diagnostic categories. This narrative review aimed to develop a more discriminating framework in which vitamin D is considered a lifespan neuroimmune and immunometabolic signal whose psychiatric relevance depends on developmental timing, biological context, and phenotype. Methods: Evidence was integrated from developmental epidemiology, neonatal dried-blood-spot studies, randomized trials, meta-analyses, Mendelian randomization studies, clinical guidelines, and mechanistic neuroscience. The review focuses on prenatal and neonatal 25-hydroxyvitamin D, vitamin D-binding protein, free and bioavailable vitamin D, vitamin D receptor signaling, immune and microglial pathways, neurotransmitter systems, neurotrophic signaling, mitochondrial function, oxidative stress, hypothalamic–pituitary–adrenal-axis regulation, and the gut–microbiota–immune–brain axis. Results: The available evidence does not support vitamin D as a universal treatment for psychiatric disorders. Instead, vitamin D deficiency and altered vitamin D biology appear most relevant in biologically and clinically defined risk states, including neurodevelopmental vulnerability, inflammatory depression, psychosis liability, severe mental illness with nutritional deprivation, metabolic comorbidity, and cognitive frailty. Mechanistic data support plausible links with cytokine biology, the tryptophan–kynurenine pathway, dopaminergic and serotonergic systems, stress regulation, and neuroimmune homeostasis. Conclusions: Vitamin D should be conceptualized in psychiatry as a context-dependent neuroimmune and immunometabolic signal rather than a generic psychotropic intervention. Future studies should prioritize biomarker-enriched, developmentally timed, nutrition-centered models of precision prevention and adjunctive care. Full article