General hospital psychiatry最新文献

{"title":"Open-label study of the efficacy, safety and tolerability of Brexanolone in the treatment of adult women with postpartum psychosis","authors":"Riah Patterson ,&nbsp;Holly Krohn ,&nbsp;Elizabeth Richardson ,&nbsp;Cecilia Pearson ,&nbsp;Kai Xia ,&nbsp;Mary Kimmel ,&nbsp;Samantha Meltzer-Brody","doi":"10.1016/j.genhosppsych.2025.10.017","DOIUrl":"10.1016/j.genhosppsych.2025.10.017","url":null,"abstract":"<div><h3>Objective</h3><div>Postpartum psychosis (PPP) is a rare but severe postpartum psychiatric emergency that occurs during a critical time in mother-infant attachment. This study investigated the efficacy, safety, and tolerability of brexanolone, a neuroactive steroid and synthetic form of allopregnanolone, for adult females with PPP.</div></div><div><h3>Methods</h3><div>In this open-label, proof-of-concept study, ten patients with PPP received brexanolone as a single, continuous, 60-h intravenous infusion titrated to a target dose of 90 μg/kg/h over a period of 2.5 days. Primary outcomes were change in total score on the Young Mania Rating Scale (YMRS) and Positive and Negative Syndrome Scale (PANSS); Secondary outcomes included change in Hamilton Depression Rating Scale (HAM<img>D) from baseline to Day 7. Adverse events were monitored. Patients were followed through Day 90.</div></div><div><h3>Results</h3><div>All ten patients completed the treatment protocol without dose reductions and without intolerable adverse side effects. Change in mean PANSS total score from baseline to Day 7 was statistically significant (<em>p</em> = 0.00006; 95 % CI [19.60–38.40]), as were YMRS scores (<em>p</em> = 0.01; 95 % CI [2.69–16.01]) and HAM-D scores (<em>p</em> = 0.0003; 95 % CI [5.22–11.98]).</div></div><div><h3>Conclusions</h3><div>This study suggests the potential for neuroactive steroids as rapid-acting, adjunctive treatment for PPP and provides support for future research to assess the role of neuroactive steroids and synthetic forms of allopregnanolone in the treatment of PPP.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 237-240"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of quetiapine prophylaxis for delirium in hospitalized adult patients: A systematic review and meta-analysis of randomized controlled trials","authors":"Raj Kiran Donthu ,&nbsp;Sneha Mary Minz ,&nbsp;Mamidipalli Sai Spoorthy ,&nbsp;R. Dyuthy ,&nbsp;A. Balaji ,&nbsp;P.S. Sethu ,&nbsp;Libnus B. Varghese ,&nbsp;Shahul Ameen ,&nbsp;Brijesh Sathian ,&nbsp;Vikas Menon","doi":"10.1016/j.genhosppsych.2025.10.011","DOIUrl":"10.1016/j.genhosppsych.2025.10.011","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to compare summary estimates of efficacy and safety of quetiapine versus comparator treatments in preventing delirium among hospitalized adult patients by pooling evidence from parallel-group randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>We searched MEDLINE, Embase, Scopus, and clinical trial registers from inception till January 31st, 2025. Our primary outcome was between-group incidence of delirium. Secondary outcomes included 10-day mortality, duration of hospital stay, duration of delirium, severity of delirium, readmission rates (efficacy outcomes), and reported adverse effects (safety outcomes).</div></div><div><h3>Results</h3><div>Six eligible RCTs (pooled <em>N</em> = 491) were identified; of these, five were included in the meta-analysis. The pooled RR for preventing the incidence of delirium was 0.61 (95 % CI, 0.45–0.83;5 RCTs; I² = 0;<em>p</em> = .001), favoring quetiapine (dose range 12.5-75 mg/day). The SMD for duration of delirium was −1.21 (95 % CI, −2.08 to −0.35; 3 RCTs; I² = 86 %; <em>p</em> = .006), again favoring quetiapine. No significant between-group differences were noted on other outcomes. Adverse effects with quetiapine were absent in four studies and minimal in the other two. The findings were robust to sensitivity analyses.</div></div><div><h3>Conclusion</h3><div>Low-dose quetiapine prophylaxis may be a safe and effective treatment option for preventing delirium. These conclusions are tempered by the small number and size of existing trials.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 192-195"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive function among stable schizophrenia patients receiving an mHealth app-based cognitive remediation therapy: randomized controlled trial with mediation analysis","authors":"Min Wen ,&nbsp;Xiaoyao Liu ,&nbsp;Ying He ,&nbsp;Weiguo Xu ,&nbsp;Yongling Zhou ,&nbsp;Juan Liu ,&nbsp;Xiaodan Zhu","doi":"10.1016/j.genhosppsych.2025.10.013","DOIUrl":"10.1016/j.genhosppsych.2025.10.013","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the application effect and underlying mechanisms of mHealth app-based cognitive remediation therapy on the cognitive function of patients with stable schizophrenia.</div></div><div><h3>Methods</h3><div>This study was a randomized controlled trial, patients received either treatment as usual or mHealth app-based cognitive remediation therapy. Guided by the theoretical framework integrating the MCI theoretical model of rehabilitation, we examined the mediating roles of self-efficacy and negative emotion in the relationship between intervention subgroups and cognitive functioning. These outcome indicators were assessed at baseline, the primary endpoint, and the follow-up endpoint. Linear mixed-effects modeling was employed to compare these measures between the two patient groups, with all analyses adhering to the intention-to-treat principle. Mediation analyses were conducted using the PROCESS. The significance of mediation effects was assessed through bias-corrected nonparametric percentile bootstrap analysis.</div></div><div><h3>Results</h3><div>Linear mixed-effects models revealed statistically significant group*time interaction effects at both the primary endpoint (post-intervention) and the follow-up endpoint (3-month post-intervention) for cognitive functioning (<em>P</em> = 0.001), psychiatric symptoms (<em>P</em> &lt; 0.001), self-efficacy (<em>P</em> &lt; 0.001), and negative emotions (<em>P</em> &lt; 0.001). Analysis of these interactions indicated that, compared to the TAU group, the CRT group demonstrated significantly greater improvement in cognitive function and self-efficacy, and significantly greater reduction in psychiatric symptoms and negative emotions over time. Mediation analyses further indicated that self-efficacy scores partially mediated the relationship between the intervention groupings and cognitive function scores (indirect effect of 0.237, 95 % CI [0.073, 0.414]). Similarly, negative emotion scores were found to partially mediate this relationship (indirect effect of 0.154, 95 % CI [0.029, 0.323]).</div></div><div><h3>Conclusion</h3><div>Cognitive remediation therapy delivered through mHealth app for patients with stable schizophrenia has been shown to effectively improve cognitive functioning. Moreover, this intervention may exert an indirect positive effect on cognitive performance mediated by negative emotions and self-efficacy.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 225-234"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social factors related to untreated post stroke depression","authors":"Alexandra Balshi ,&nbsp;John Dempsey ,&nbsp;Matthew Z. Farber ,&nbsp;Adam Jiadi ,&nbsp;Harish Babu","doi":"10.1016/j.genhosppsych.2025.09.007","DOIUrl":"10.1016/j.genhosppsych.2025.09.007","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 94-95"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between COVID-19 infection and risk of mental disorders: a systematic review and meta-analysis","authors":"Jiayi Liu ,&nbsp;Honghao Lai ,&nbsp;Weilong Zhao ,&nbsp;Jiajie Huang ,&nbsp;Bei Pan ,&nbsp;Janne Estill ,&nbsp;Long Ge","doi":"10.1016/j.genhosppsych.2025.10.008","DOIUrl":"10.1016/j.genhosppsych.2025.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review and meta-analyse the association between COVID-19 and the risk of mental disorders.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, CINAHL, PsycINFO, and the reference lists of systematic reviews and included cohort studies assessing the association between COVID-19 and mental disorders. Two reviewers independently performed literature screening, data extraction, and the risk of bias assessment. We conducted a random-effect meta-analysis to assess the association and calculated the pooled risk ratio with 95 % confidence interval.</div></div><div><h3>Results</h3><div>Twenty-eight cohorts with a total of 977,434,207 participants proved eligible. We revealed a 40 % increased risk (RR = 1.40, 95 %CI: 1.23 to 1.59; absolute risk difference = 31 more per 1000 persons, 18 more to 45 more) of mental disorders in patients with COVID-19 compared with non-exposed individuals. Moreover, COVID-19 may be related to the risks of anxiety or fear-related disorders, mood disorders, bipolar or related disorders, depressive disorders, unspecified mood disorders, neurocognitive disorders, dementia, mild cognitive disorders, unspecified neurocognitive disorders, psychotic disorders, stress and adjustment disorders, post-traumatic stress disorder, unspecified stress and adjustment disorders, and prescriptions for psychotropic medications.</div></div><div><h3>Conclusions</h3><div>Our findings suggest an association between COVID-19 and risk of mental disorders, as well as the prescriptions for psychotropic medications. It is imperative for individuals to become vigilant of mental health problems that may arise following COVID-19.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 130-143"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key competencies for psychedelic treatment in real-world mental health care settings","authors":"Max Wolff ,&nbsp;Hans Rutrecht ,&nbsp;Gerhard Gründer ,&nbsp;Andrea Jungaberle ,&nbsp;Henrik Jungaberle","doi":"10.1016/j.genhosppsych.2025.09.003","DOIUrl":"10.1016/j.genhosppsych.2025.09.003","url":null,"abstract":"<div><div>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 of these treatments, the competencies framework we present respects the distinctive contextual and cultural sensitivities of psychedelic care while remaining anchored in established psychotherapeutic, medical, and scientific paradigms. Designed for varied service models, the framework is substance-unspecific (i.e., covering various classical and atypical psychedelic agents) and transtheoretical (i.e., compatible with cognitive-behavioral, psychodynamic, humanistic-experiential, systemic and other psychotherapeutic orientations). Developed within the MIND Foundation's Augmented Psychotherapy Training (APT) program, the framework spans foundational psychotherapeutic, biomedical, philosophical, socio-cultural, existential, legal, and self-experiential domains and translates them into practical competencies for multi-professional cooperation, screening, preparation, dosing, integration, and harm-reduction. While the framework awaits systematic evaluation across diverse clinical contexts, it offers an initial blueprint for future accredited certification pathways and for the ongoing refinement of clinician training as these treatments enter mainstream care.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 11-24"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is intranasal esketamine versus intravenous ketamine a therapeutic innovation or a divide in access to care?","authors":"Yassine Benhaddouch,&nbsp;Adil El Ammouri","doi":"10.1016/j.genhosppsych.2025.10.005","DOIUrl":"10.1016/j.genhosppsych.2025.10.005","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 170-171"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Set and setting in psilocybin-assisted therapy: A qualitative study of patients with cancer and depression","authors":"Yvan Beaussant ,&nbsp;Elise Tarbi ,&nbsp;Kabir Nigam ,&nbsp;Skye Miner ,&nbsp;Zachary Sager ,&nbsp;Justin Sanders ,&nbsp;Michael Ljuslin ,&nbsp;Benjamin Guérin ,&nbsp;Roxanne Sholevar ,&nbsp;Kimberly Roddy ,&nbsp;James A. Tulsky ,&nbsp;Manish Agrawal","doi":"10.1016/j.genhosppsych.2025.10.010","DOIUrl":"10.1016/j.genhosppsych.2025.10.010","url":null,"abstract":"<div><h3>Background</h3><div>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 from the perspective of patients with cancer and depression.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with participants in a clinical trial of psilocybin-assisted therapy. Using template analysis, we examined themes related to the acceptability of the experience and the surrounding therapeutic environment.</div></div><div><h3>Results</h3><div>Participants (<em>n</em> = 28) described the psilocybin experience as intense and demanding, with therapeutic benefits closely tied to their ability to “surrender”—a term used to describe accepting and remaining open to the experience's intensity and unpredictability. A safe, supportive, and ethical environment was critical in fostering trust and engagement. Preparation and integration were key to maximizing benefit. Music played a significant but variable role, sometimes enhancing and other times distracting. While the clinical setting provided safety, ceremonial elements added meaning for many.</div></div><div><h3>Conclusions</h3><div>Findings highlight how therapeutic structure, preparation, and setting shape PAT acceptability, supporting the need for patient-centered approaches to optimize care and outcomes.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 175-184"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between cognitive function and depressive symptoms in Chinese older adults: A cross-lagged panel network analysis","authors":"Shuaichen Li ,&nbsp;Jinglan Tan ,&nbsp;Yanwei Guo ,&nbsp;Junyao Li ,&nbsp;Renqin Hu ,&nbsp;Jiayi Ge ,&nbsp;Yiran Feng ,&nbsp;Wenjing Zhao ,&nbsp;Qinghua Luo","doi":"10.1016/j.genhosppsych.2025.10.016","DOIUrl":"10.1016/j.genhosppsych.2025.10.016","url":null,"abstract":"<div><h3>Background</h3><div>The bidirectional association between depressive symptoms and cognitive decline has been extensively studied in Western populations, yet empirical evidence from non-Western contexts, particularly among Chinese older adults, remains limited. This study aimed to examine the longitudinal and symptom-level dynamics between depressive symptoms and cognitive functioning using a cross-lagged panel network (CLPN) approach.</div></div><div><h3>Methods</h3><div>Data were drawn from two waves (2015, 2018) of the China Health and Retirement Longitudinal Study (CHARLS), including 6824 individuals aged 50 years and above. Cognitive performance was assessed via the China Mini-Mental State Examination (CMMSE), and depressive symptoms were measured using the 8-item Center for Epidemiological Studies Depression Scale (CESD-8). A CLPN model was estimated to identify temporally predictive pathways and symptom-level interactions, with LASSO regularization ensuring model sparsity. Model stability was evaluated through nonparametric bootstrapping.</div></div><div><h3>Results</h3><div>Findings revealed a reciprocal, predominantly negative relationship between cognitive decline and depressive symptoms over time. “Mental State” (orientation, processing, and visuospatial skills) emerged as the central network hub and primary bridge from cognition to depression, while lack of motivation (“ I felt everything was an effort”) was the pivotal bridge symptom from depression to cognition. Specifically, “I felt everything was an effort” predicted subsequent declines in memory function, whereas better mental state predicted reduced depressive symptoms, including feeling depressed, trouble concentrating, and restless sleep. The network model highlighted symptom-specific pathways not observable in traditional latent variable models.</div></div><div><h3>Conclusions</h3><div>This study underscores the clinical and public health value of integrated screening and interventions targeting both depressive symptoms and cognitive impairment in older adults. Motivational deficits and mental state deficits may serve as actionable transdiagnostic targets. Future interventions should be symptom-specific, modular, and culturally sensitive. Longitudinal neurobiological studies are warranted to elucidate underlying mechanisms.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 203-208"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psilocybin-assisted psychotherapy for depression and anxiety associated with life threatening illness: A phase 2b randomized controlled trial","authors":"Margaret L. Ross ,&nbsp;Ravi Iyer ,&nbsp;Martin L. Williams ,&nbsp;Mark Boughey ,&nbsp;Clare O'Callaghan ,&nbsp;Richard Hiscock ,&nbsp;Justin Dwyer","doi":"10.1016/j.genhosppsych.2025.08.001","DOIUrl":"10.1016/j.genhosppsych.2025.08.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Importance&lt;/h3&gt;&lt;div&gt;Psilocybin-assisted psychotherapy may offer a novel approach to treating depression, anxiety, and existential distress in individuals with life threatening illnesses, where current treatments show limited efficacy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the efficacy and safety of psilocybin-assisted psychotherapy versus active placebo and psychotherapy in adults with life-threatening illnesses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Double-blind, randomized controlled phase 2b trial (RCT) with an open-label extension and 6-month follow-up (January 2020 – October 2023).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Single-site study at a tertiary hospital's palliative care department (St. Vincent's Hospital Melbourne affiliated with the University of Melbourne).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Adults aged 18–80 with a life-threatening illness and clinically significant depression and/or anxiety.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Participants were randomized to receive 25 mg psilocybin or 100 mg niacin (active placebo), alongside three preparatory psychotherapy and six post-dose integration psychotherapy sessions. After 6–7 weeks post double blind dose, all participants received 25 mg psilocybin in an open-label extension, enabling a two dose versus one dose group comparator. Participants were followed up to 26 weeks post open label dose.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main outcomes and measures&lt;/h3&gt;&lt;div&gt;Primary outcome was change in depression and anxiety symptoms, assessed using the Hospital Anxiety and Depression Scale (HADS), from baseline to 6–7 weeks post-dose. Key secondary outcomes included the Beck Depression Inventory-II (BDI-II) and the State-Trait Anxiety Inventory – State version (STAI-S), which provided complementary, dimensional measures of depression and anxiety over the same time period.&lt;/div&gt;&lt;div&gt;Additional secondary outcomes included Death Attitudes Profile, WHOQOL-BREF, State-Trait Anxiety Inventory (STAI-Trait scale), Mystical Experiences Questionnaire, and Persisting Effects Questionnaire. Exploratory outcomes included spiritual well-being, hopelessness, demoralization, and HADS-Trait scores.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Thirty-five participants (mean age 56.0; 54.3 % female) were randomized (psilocybin: n = 17; placebo: n = 18). At 6–7 weeks, psilocybin produced significantly greater reductions in HADS depression (B = –2.49; P = .02; d = 1.12), BDI-II (B = –7.56; P = .004; d = 2.97), and STAI-State anxiety (B = –12.59; P = .005; d = 4.51) compared to placebo. Benefits were sustained at 26 weeks. Exploratory outcomes demonstrated enhanced spiritual well-being, quality of life, and significant reductions in demoralization, death anxiety and hopelessness. No serious treatment-emergent adverse events occurred. Psilocybin was associated with more mild-to-moderate adverse events. One participant withdrew due to anxiety during dosing.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and relevance&lt;/h3&gt;&lt;div","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"Pages 322-331"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}