Search Results (31)

Background: This systematic review and meta-analysis evaluates the efficacy and safety of psilocybin-assisted psychotherapy (PAP) for adults with major depressive disorder (MDD). Methods: A PROSPERO-registered search (CRD42024561979) of CENTRAL, Scopus, PsycINFO, and MEDLINE (2010–2024) identified clinical trials assessing PAP. Risk of bias was assessed using RoB 2 for randomized controlled trials (RCTs), while non-randomized studies were appraised separately. Evidence certainty was evaluated using GRADE. Results: Ten trials were included; eight provided quantitative data. PAP was associated with large short-term reductions in depressive symptom severity. The overall pooled effect was large (d = 1.15, 95% CI 0.83–1.48), though within-subject designs yielded 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. Primary risk-of-bias concerns included functional unblinding. Conclusions: PAP may produce clinically meaningful, large short-term reductions in depressive symptoms. However, long-term efficacy remains understudied, and the overall certainty of evidence is low to moderate. Larger, rigorously blinded trials are required. Full article

Benzodiazepines (BZDs) are among the most widely prescribed psychotropic drugs in modern healthcare, primarily used as anxiolytics, hypnotics, anticonvulsants, and muscle relaxants. However, rising global consumption and prolonged use raise significant concerns about safety and dependence. Recent studies report that up to 35.8% of patients continue BZD therapy beyond three months, with long-term use observed in over 5% of the general population. These patterns highlight the need for evidence-based strategies to improve prescribing practices. BZDs are recommended primarily for short-term management of severe anxiety or transient insomnia, typically limited to 2–4 weeks. In anxiety disorders, SSRIs and SNRIs are first-line treatments. BZD use is particularly discouraged in older adults due to increased risks of cognitive impairment, falls, and dependence. Rational prescribing requires individualized assessment, minimal effective dosing, gradual withdrawal protocols, and patient education. Enhanced regulatory oversight and improved access to psychotherapy are essential for safer benzodiazepine use. Full article

Background/Objectives: Positive Psychotherapy (PPT) is an empirically supported treatment that directly targets positive resources and personal strengths as its primary logic. PPT is effective in amplifying happiness and well-being as an additional way to enhance positive mental health while also ameliorating symptoms of negative affect, especially in depression, anxiety disorders, and stress disorders. However, few studies have been conducted to investigate these effects in the long run. This study extends our previously published findings on the short-term efficacy of PPT by extending the follow-up period to 18 months and comparing its long-term effects with those of Cognitive Behavioral Therapy (CBT) within the same randomized controlled trial. Methods: Forty-nine out-patient participants with a DSM-IV diagnosis for depressive disorder (MDD, Dysthymia) were treated with 14 sessions of manualized PPT (n = 23) or CBT (n = 26) group therapy. In a randomized controlled two-center-study, questionnaires on depressive symptoms (BDI-II, MADRS, DHS), psychological distress (BSI), and well-being related outcomes (FS, PPTI, SWLS) were administered at baseline and 18-month follow-up. Results: Analyses using linear mixed models indicated significant differences in long-term treatment outcome for depressive symptoms (BDI-II, DHS, MADRS) and satisfaction with life (SWLS), depicting better outcomes for the PPT group. Between group effect sizes at 18-month follow-up were primarily in the middle range for all outcome measures, in favor of PPT. Conclusions: This study provides support for the long-term efficacy of PPT in the treatment of depression and improvement of positive resources. Full article

Background: Cognitive behavioral therapy (CBT) is the most established psychological treatment for generalized anxiety disorder (GAD), yet many patients do not achieve full remission. Brief psychoanalytic psychotherapy represents a theoretically distinct alternative, but direct controlled comparisons remain limited. This study examined the short-term efficacy of brief psychoanalytic psychotherapy and CBT relative to a waitlist control in adults with GAD. Methods: In a three-arm randomized controlled trial, 60 adults with DSM-5-diagnosed GAD were allocated to brief psychoanalytic psychotherapy (12 weekly sessions), CBT (12 weekly sessions), or a waitlist control. Assessments were conducted at pre-treatment and post-treatment. The primary outcome was anxiety severity measured by the Beck Anxiety Inventory (BAI). Secondary outcomes included depressive symptoms (BDI-II), quality of life (WHOQOL-BREF), functional impairment (WHODAS 2.0), and therapeutic alliance (Working Alliance Inventory). Data were analyzed using mixed-design ANOVAs and effect size estimates. Results: Both active treatments produced significantly greater reductions in anxiety than the waitlist control, with large effect sizes. Mean BAI scores decreased by 14.5 points in the psychoanalytic group and 16.3 points in the CBT group, compared to minimal change in the waitlist condition. Similar patterns were observed for depressive symptoms, quality of life, and functional impairment, with both therapies outperforming waitlist controls on all secondary outcomes. No statistically significant differences were found between CBT and brief psychoanalytic psychotherapy on any outcome measure. Therapeutic alliance ratings were high and comparable across the two active treatments. Conclusions: Brief psychoanalytic psychotherapy and CBT were both effective short-term treatments for GAD and superior to no treatment, with no significant differences between the two modalities at post-treatment. These findings suggest that time-limited psychoanalytic psychotherapy may represent a promising short-term therapeutic option to CBT for GAD, expanding treatment options for patients and clinicians. Full article

This systematic review examines 205 studies on the use of Large Language Models (LLMs) in psychiatry, psychology, psychotherapy, and clinical workflows. Furthermore, studies that directly evaluated at least one LLM in a mental health context were included in the extended detailed analysis. GPT-4 and GPT-3.5 were the most commonly assessed models. Although LLMs showed promising short-term performance across domains, most evaluations relied on small, non-longitudinal datasets and single-session testing, limiting generalizability. The evidence indicates rapid growth but significant methodological inconsistency, emphasizing the need for more diverse datasets, standardized evaluation, and long-term validation before clinical integration. This review also examines how LLMs are being incorporated into mental health practice, outlining key challenges, limitations, and emerging opportunities. Ethical, clinical, and technological considerations are proposed to guide responsible adoption. Given the complexity of mental health care, a multidisciplinary, human-centered approach remains essential to ensure that future LLM applications augment—rather than replace—professional expertise. Full article

Background: Studies on the organization and structure of dreams before and after acute myocardial infarction (AMI) are lacking. Methods: We retrospectively studied dream patterns before and after AMI in the STEP-IN-AMI trial (Short-TErm Psychotherapy IN Acute Myocardial Infarction). We also performed an analysis to describe how this pattern may change during ontopsychological short-term psychotherapy (STP) performed after AMI. Forty-seven patients (pts) aged 31–70 were studied. Results: At baseline, 21/47 (45%) pts remembered dreams, which increased to 43/47 (91%) with psychotherapy (p < 0.0001). Recurring dreams, described as a state of anguish, despair, perceived inability to complete an action, or grief over one’s mother’s early death, occurred before AMI in 16/47 pts (24%). After the third psychotherapy session, no pts reported recurring dreams (p < 0.001). In dreams that occurred during the year before AMI, 12 of 25 symbols referred to people known to pts and who had died of a cardiac disease; 9 of 25 symbols referred to an accident, danger, or distressing events. Overall, 21 of 25 symbols were associated with danger to an individual’s life (84%). The incidence of “negative” symbols was sharply reduced during psychotherapy, from 84% to 32% during the first three psychotherapy sessions and to 9% in the last phase of psychotherapy (p < 0.0001). Conclusions: Our study is the very first on dreams in pts with AMI, and it also examines how STP may change dream patterns in this cohort of pts. AMI pts frequently do not remember dreams that occurred before AMI or report distressing dreams. STP after AMI significantly increased their ability to remember dreams and sharply reduced the incidence of negative/distressing dreams. The results suggest that (1) dream symbols may be connected to the biological status of the dreamer, warning the dreamer of their cardiac condition; (2) ontopsychological STP may act as a stimulus for inner personal change for AMI pts. Full article

Micro-expressions are facial movements with extremely short duration and small amplitude, which can reveal an individual’s potential true emotions and have important application value in public safety, medical diagnosis, psychotherapy and business negotiations. Since micro-expressions change rapidly and are difficult to detect, manual recognition is a significant challenge, so the development of automatic recognition systems has become a research hotspot. This paper reviews the development history and research status of micro-expression recognition and systematically analyzes the two main branches of micro-expression analysis: micro-expression detection and micro-expression recognition. In terms of detection, the methods are divided into three categories based on time features, feature changes and deep features according to different feature extraction methods; in terms of recognition, traditional methods based on texture and optical flow features, as well as deep learning-based methods that have emerged in recent years, including motion unit, keyframe and transfer learning strategies, are summarized. This paper also summarizes commonly used micro-expression datasets and facial image preprocessing techniques and evaluates and compares mainstream methods through multiple experimental indicators. Although significant progress has been made in this field in recent years, it still faces challenges such as data scarcity, class imbalance and unstable recognition accuracy. Future research can further combine multimodal emotional information, enhance data generalization capabilities, and optimize deep network structures to promote the widespread application of micro-expression recognition in practical scenarios. Full article

The aim of this paper is to contribute to the further development of a coherent theory of music performance anxiety (MPA) and its treatment. I have previously proposed three forms of MPA-focal, MPA with social anxiety, and MPA with panic and/or depression. An attachment disorder was proposed as a possible underlying psychopathology for this third type of MPA. Accordingly, open-ended in-depth assessment interviews of three professional musicians presenting with severe MPA that included panic attacks and depressed mood were analyzed from an attachment theory perspective. Two of these musicians participated in short-term psychodynamic psychotherapy. It was hypothesized that the musical performance setting re-triggers unprocessed feelings related to early attachment trauma, and that performance anxiety can be a manifestation of the emergence into consciousness of these powerful early feelings. As hypothesized, severely anxious musicians suffered both early and current relational trauma that was expressed through symptomatology in their MPA manifestations. The assessment interview of the first musician demonstrated how MPA can arise in the midst of other challenging current life circumstances that re-trigger feelings about early attachment failures and the importance of taking a full life history from severely performance-anxious musicians. Excerpts from the two musicians’ short-term psychodynamic psychotherapy demonstrated resolution of their severe MPA. Failure to identify and treat underlying attachment disorders in severely anxious musicians may render other forms of treatment ineffective or short-lived. Full article

Background: Cognitive functions and brain connectivity could be influenced by psychoanalytic psychotherapy (PP), thus representing neurobiological parameters for therapy-induced changes. This study searched empirical studies on cognition and the brain to evaluate which functions have been assessed, with which instruments, and what changes have been documented in brain connectivity after PP. Methods: We used the guidelines and checklist of the Preferred Reporting Items of Systematic Reviews and Meta-analyses Extension for Scoping Reviews. The literature search was performed on the Medline–PubMed, American Psychological Association-PsycINFO, Elton Bryson Stephens Company, and Cochrane databases, and Google Scholar, including articles on patients with non-psychotic disturbances published from 1980 to September 2024. Results: Fifty-nine articles were collected. Five articles reported on cognitive outcomes. Abstraction and mentalization remained stable after individual PP in patients with adjustment disorders or anorexia nervosa. Executive functions, emotional intelligence, spatial short-term memory, attention, and balance between relatedness and self-definition improved after group PP applied alone or combined with individual PP. Twelve studies using functional magnetic resonance imaging, positron emission tomography, single-photon emission computerized tomography, or electroencephalography showed functional brain changes after different types of PP. Conclusions: An empirical approach has rarely been used to evaluate the impact of PP on the brain and cognition. The results of selected studies on neurotic and depressive disorders suggest that PP can stimulate cognitive function and brain connectivity. Further literature reviews are needed to clarify these issues and provide an avenue for research studies targeting PP in different conditions. Communication between neurology and psychoanalysis is indispensable. Full article

Background/Objectives: Bipolar disorder (BD) is a chronic, severe mental health condition characterized by episodes of mood instability, including manic and depressive episodes. While pharmacological interventions remain foundational in BD treatment, psychotherapy offers significant benefits by addressing the psychological and behavioral components that contribute to mood episodes and overall functioning. The primary objective of this short communication is to propose new directions in psychotherapy for treating bipolar disorder, focusing on integrative models that combine evidence-based therapies such as Cognitive Behavioral Therapy (CBT), Interpersonal and Social Rhythm Therapy (IPSRT), Family-Focused Therapy (FFT), and mindfulness-based approaches. By integrating these therapies, clinicians can target both cognitive distortions and emotional dysregulation while simultaneously stabilizing sleep–wake cycles and improving interpersonal functioning. The secondary objective emphasizes the importance of better understanding and psychoeducation in family therapy, which can promote a better understanding of BD among family members and ensure more effective management of the disorder in daily life. Methods: We explore the potential of Cognitive Behavioral Therapy (CBT), Interpersonal and Social Rhythm Therapy (IPSRT), Family-Focused Therapy (FFT), and mindfulness-based interventions in enhancing symptom management and preventing relapse. Results: We identified psychoeducation and family therapy as critical components in supporting patients and improving treatment adherence. These therapeutic interventions play a pivotal role in enhancing patient engagement, improving coping strategies, and facilitating better overall treatment outcomes. Conclusions: We propose a multidisciplinary approach, integrating psychotherapy with pharmacotherapy, to optimize long-term outcomes and improve the overall quality of life for individuals with bipolar disorder. Full article

Speech emotion recognition (SER) plays an important role in human-computer interaction (HCI) technology and has a wide range of application scenarios in medical medicine, psychotherapy, and other applications. In recent years, with the development of deep learning, many researchers have combined feature extraction technology with deep learning technology to extract more discriminative emotional information. However, a single speech emotion classification task makes it difficult to effectively utilize feature information, resulting in feature redundancy. Therefore, this paper uses speech feature enhancement (SFE) as an auxiliary task to provide additional information for the SER task. This paper combines Long Short-Term Memory Networks (LSTM) with soft decision trees and proposes a multi-task learning framework based on a decision tree structure. Specifically, it trains the LSTM network by computing the distances of features at different leaf nodes in the soft decision tree, thereby achieving enhanced speech feature representation. The results show that the algorithm achieves 85.6% accuracy on the EMO-DB dataset and 81.3% accuracy on the CASIA dataset. This represents an improvement of 11.8% over the baseline on the EMO-DB dataset and 14.9% on the CASIA dataset, proving the effectiveness of the method. Additionally, we conducted cross-database experiments, real-time performance analysis, and noise environment analysis to validate the robustness and practicality of our method. The additional analyses further demonstrate that our approach performs reliably across different databases, maintains real-time processing capabilities, and is robust to noisy environments. Full article

Background: This systematic review aggregates research on psychotherapeutic interventions for Post-Traumatic Stress Disorder (PTSD) in children and adolescents. PTSD in this demographic presents differently from adults, necessitating tailored therapeutic approaches. In children and adolescents, PTSD arises from exposure to severe danger, interpersonal violence, or abuse, leading to significant behavioral and emotional disturbances that jeopardize long-term development. The review focuses on describing PTSD within two age groups, children (6 to 12 years) and adolescents (12 to 18 years), while evaluating the effectiveness of various clinical interventions aimed at this condition. Methods: Utilizing the PRISMA guidelines, this review systematically examines studies that assess clinical interventions for PTSD in the younger population. Results: Key symptoms of PTSD in children and adolescents include avoidance, overstimulation, flashbacks, depression, and anxiety. The review identifies several effective treatments, including Cognitive Behavioral Therapy (CBT), Trauma-Focused CBT (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), Systemic Therapy, Play Therapy, Exposure Therapy, Relaxation Techniques, and Psychodynamic Psychotherapy. Particularly, TF-CBT is highlighted as the most effective and commonly used method in treating childhood and adolescent PTSD, as supported by most of the studies reviewed. Conclusions: A significant outcome of this study is the short-term effectiveness of CBT in reducing PTSD symptoms in children and adolescents. The findings underline the importance of psychotherapeutic interventions and mark a substantial advancement in understanding PTSD in young populations. It is crucial for practitioners to integrate various psychotherapeutic strategies into their practice to improve patient outcomes and treatment efficacy. Full article

Adventure Therapy (AT) is a therapeutic intervention utilizing the natural environment and adventure activities as tools for psychotherapeutic interventions. It has been demonstrated to be appropriate for the intervention of patients with borderline personality disorder (BPD). This study aims to evaluate the response to AT treatment compared with the response to treatment as usual (TAU), based on cognitive behavioural therapy, in the short and long term, assessing clinical, psychosocial, and functional outcomes; quality of life; and physical health levels. This study extends the sample of and is a follow-up to a pilot study published in 2021, with a sample of 30 patients in the AT group and 10 in the control group. It does not allow us to affirm that AT provides better outcomes than TAU, as the positive effects observed immediately after therapy seem to be attenuated in the long term. Therefore, the effectiveness of long-term psychotherapy did not show differences between AT and TAU therapies in the treatment of BPD patients. However, the effects of intangibles observed during therapy by professionals and patients were not reflected in the measurements collected. Therefore, we believe it is necessary to increase the programme duration, complement treatment with a specific physical health programme, assess results with more specific instruments, and/or move towards a qualitative methodology to measure perceived changes in clinical improvement. New studies are needed to evaluate the results of the proposed changes. Full article

While psychotherapy incorporating equine interaction (PIE) has proven to be a viable therapeutic intervention, it is not a common mental health service found on college campuses. Nevertheless, with the rise of mental health challenges on campuses after the COVID-19 pandemic, a need for effective therapeutic solutions is warranted. Therefore, the objective of this study was to determine the effect of a collegiate recovery community (CRC) PIE program for substance abuse disorder (SUD) compared to that of traditional cognitive behavioral therapy (CBT) and to determine whether physiological synchronization occurs between the human and horse during the therapy process. College-aged adults were recruited during the COVID-19 pandemic for two types of short-term SUD therapeutic interventions, CRC-PIE and CBT. Both groups completed a self-reporting survey assessing emotional safety. Vital signs measurements for human and horse participants within the CRC-PIE were collected prior to and after the first and last therapeutic sessions. Results concluded that although emotional safety did not improve significantly for PIE participants by the last therapy session (p = 0.85), emotional safety scores were significantly different between therapy types, with lower post-therapy scores for PIE (p = 0.04). As for physiological measures for PIE participants, respiratory rates (Human: p = 0.01; Horse: p = 0.01) and pain rating scores (Human: p = 0.03; Horse: p = 0.01) significantly decreased post-therapy and a strong positive correlation (R = 0.73, R² = 0.53) associated with vital signs was observed between humans and horses. This human–horse physiological synchronization during the therapeutic intervention suggests that the horse may be a viable tool within campus CRC programs for the development of therapeutic alliances within the therapy process. Full article

Following the introduction of the 11th revision of the International Classification of Diseases (ICD-11), adolescents can now be diagnosed with a personality disorder based on severity ranging from mild to moderate to severe. This dimensional model has potential implications for treatment, as it allows clinicians and researchers to search for effective treatments targeting adolescents at different severity levels rather than offering all patients the same treatment. In this conceptual paper, we propose that the short-term mentalization-based therapy (MBT) program, originally developed to treat adults with borderline personality disorder (BPD), has potential clinical advantages for adolescents with ICD-11 personality disorder at the mild to moderate severity level. The short-term MBT program is a 5-month structured treatment approach including individual therapy, combined psychotherapy with the individual therapist also being one of the group therapists, and closed-group therapy to enhance cohesion and a feeling of security. The purpose of this paper is to make a case for the use of this format, as opposed to the traditional long-term MBT format, for adolescents with BPD. Future research should include large-scale randomized clinical trials powered to assess patient-important outcomes. Full article