Abstract Background Expressive writing about a traumatic event is promising in treating posttraumatic stress disorder (PTSD) symptoms in adult trauma survivors. To date, the comparative efficacy and acceptability of this approach is uncertain. Therefore, we aimed to examine the comparative efficacy and acceptability of expressive writing treatments. Methods We included 44 RCTs with 7724 participants contributing 54 direct comparisons between expressive writing (EW), enhanced writing (i.e. including additional therapist contact or individualized writing assignments; EW+), PTSD psychotherapies (PT), neutral writing (NW), and waiting-list control (WL). Results EW, EW+, PT, and NW were statistically significantly more efficacious than WL at the longest available follow-up, with SMDs (95% CI) of −0.78 (−1.10 to −0.46) for PT, −0.81 (−1.02 to −0.61) for EW+ , −0.43 (−0.65 to −0.21) for EW, and −0.37 (−0.61 to −0.14) for NW. We found small to moderate differences between the active treatments. At baseline mean PTSD severity was significantly lower in EW+ compared with WL. We found considerable heterogeneity and inconsistency and we found elevated risk of bias in at least one of the bias dimensions in all studies. When EW+-WL comparisons were excluded from the analyses EW+ was no longer superior compared with EW. Conclusions The summarized evidence confirms that writing treatments may contribute to improving PTSD symptoms in medium to long-term. Methodological issues in the available evidence hamper definite conclusions regarding the comparative efficacy and acceptability of writing treatments. Adequately sized comparative randomized controlled trials preferably including all four active treatment approaches, reporting long-term data, and including researchers with balanced preferences are needed.

Psychedelics, derived from the Greek words "psyche" (soul) and "deloun" (revealing), are substances historically and currently considered "soul-revealing". Also termed hallucinogens due to their impact on sensory perception, they are further categorized into hallucinogens, such as lysergic acid diethylamide (LSD), psilocybin, and mescaline; entactogens or empathogens, such as 3,4-methylenedioxymethamphetamine (MDMA); and dissociatives, such as phencyclidine (PCP) and ketamine. The concept of using these substances to enhance psychotherapy emerged in the 1940s, leading to the first wave of psychedelic research, which yielded promising initial results. Following a period of restricted research, modern investigations began anew around 20 years ago. In this review, we analyze the last 10 years of research, exploring the potential of psychedelics in psychotherapy. Current evidence reveals that psychedelic-assisted psychotherapy remains an experimental approach. While preliminary studies suggest potential therapeutic benefits in treating various conditions, including depression, post-traumatic stress disorder, obsessive-compulsive disorder, and substance use disorders, a definitive assessment of efficacy and safety is hampered by the scarcity of large-scale, rigorous clinical trials. Psychedilics should rather be viewed as integral components of broader therapeutic frameworks than as standalone treatment. The unique mechanisms of psychedelics, notably their effect on neuroplasticity, hint at the potential to address treatment gaps in patients unresponsive to conventional methods. However, this potential requires validation through larger, more rigorously designed studies. Future research must prioritize high-quality, randomized, double-blind, placebo-controlled trials encompassing diverse populations to produce reliable, generalizable findings and ensure responsible clinical implementation. The aim of this article is to review the current status of psychedelic-assisted psychotherapy.

ABSTRACT There is a large proportion of people living with chronic pain who also experience posttraumatic stress symptoms; however, there is no current standard treatment for addressing these mutually maintaining conditions. The aim of this systematic review and meta-analysis was to examine the efficacy of psychotherapeutic interventions for adults with chronic pain and trauma symptoms, where the effects of psychotherapy could be isolated. Systematic searches were conducted in 5 databases (MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and APA PsycINFO) until October 8, 2025. Randomized controlled trials were included if they had a psychological intervention component addressing chronic pain and/or trauma exposure/trauma-related symptoms. Methodological quality was assessed using the Cochrane risk of bias tool. Eighteen studies met our inclusion criteria with 61% having high risk of bias. The results revealed that psychological interventions were found to significantly reduce pain intensity (SMD = 0.34 [95% CI, 0.10-0.58]), pain interference (SMD = 0.20 [95% CI, 0.004-0.39]), and trauma-related symptoms (SMD = 0.36 [95% CI, 0.22-0.51]), as compared with controls, immediately after the interventions with sustained effects 3 to 6 months postintervention (SMD = 0.40 [95% CI, 0.29-0.52], SMD = 0.20 [95% CI, 0.05-0.36], and SMD = 0.38 [95% CI, 0.20-0.55]). Our findings suggest that psychological interventions may effectively reduce pain and trauma symptoms in populations with overlapping pain and trauma-related presentations, but larger, rigorous trials are needed to identify mechanisms of change and determine which interventions work best for whom.

Relevance. Our country has fully experienced the incomprehensibility and fragility of the modern world with the beginning of the anti-terrorist operation in eastern Ukraine, later going through the COVID-19 pandemic with all its devastating consequences, and finally suffering a treacherous attack from a neighboring state that until recently positioned itself as “fraternal”.It is understandable that all of this has significantly influenced the overall anxiety, fear of the future, and lack of trust of the population as a whole, subjecting large segments of the population to an increased risk of developing post-traumatic stress disorder (PTSD) associated with being in a combat zone, among military personnel and war veterans, among forced migrants, and among those who have experienced violence and torture. Obtaining effective treatment is crucial for reducing disorder symptoms and improving functioning. Modern treatment options for PTSD include both psychological and pharmacological interventions. Since we currently have a large influx of patients with post-traumatic stress disorders, both as a result of combat stress and other mass stressors, it is necessary to review approaches to the treatment of such patients and choose the most effective and accessible ones for the majority of specialists. Of course, the effectiveness of trauma-focused psychotherapeutic methods is difficult to overestimate, and most of our professionals have undergone or are undergoing training in their application. However, one should not forget about the vast arsenal of available and effective medications that can effectively prepare a patient for psychotherapeutic treatment or serve as a complement to psychotherapy. Objective. The objective of our study was to investigate the effectiveness of the atypical antipsychotic aripiprazole in the comprehensive treatment of PTSD and its mechanisms of influence on different clusters of PTSD, as well as comorbid disorders. Materials and Methods. A literature analysis was conducted on the effectiveness of various PTSD therapy methods, including chronic complex PTSD and PTSD with comorbid psychiatric disorders and addictions. Our own clinical studies are being carried out on patients with PTSD undergoing inpatient and outpatient treatment at the “Prykarpatskyi Regional Clinical Mental Health Center of the Ivano-Frankivsk Regional Council” and the First Volunteer Surgical Hospital of the “BRASS” clinic. The group primarily consisted of males aged 21 to 45 with PTSD related to military actions and verified according to contemporary diagnostic criteria. Clinical-psychopathological examination and psychodiagnostic methods were used, including the Clinical-Administered PTSD Scale (CAPS) for clinical diagnosis of PTSD, the Hospital Anxiety and Depression Scale (HADS), the Dissociative Experiences Scale (DES), Richard Lazarus' Psychological Diagnosis of Coping Behavior Strategy, the Quality of Life Assessment Scale (Chaban O.S., 2008), and others. A follow-up method was also employed to assess the results of the comprehensive treatment program. It should be noted that this article serves as a preliminary report, and the statistically analyzed results of the study will be reported in our future publications. Results. Aripiprazole can be considered one of the most promising antipsychotic agents for the treatment of post-traumatic stress disorders in a comprehensive approach alongside psychotherapy, and in certain cases, as monotherapy, considering its broad spectrum of action and minimal side effects. The key to successful treatment is the establishment of trusting and collaborative relationships with the patient when prescribing medication. Psychological preparation of patients regarding side effects, necessary dosages, treatment duration, and compliance can significantly improve outcomes. It is necessary to consider and discuss side effects, as well as weigh the risks and benefits of continued treatment. It is important to di

Background/Objectives: Borderline personality disorder (BPD) is a complex psychiatric condition marked by emotional dysregulation, interpersonal instability, and impulsivity. Despite the advances in psychotherapy and pharmacotherapy, many patients show a partial or unstable response. Recent research suggests that oxytocin, a neuropeptide involved in social cognition and emotional regulation, may offer novel therapeutic avenues. Methods: We systematically synthesize evidence from PubMed, PsycINFO, Web of Science, and Google Scholar on oxytocin’s role in BPD, prioritizing studies on neurobiology, emotion regulation, clinical interventions, and adjunctive therapy models. Thirty studies were included and critically appraised using PRISMA and Cochrane’s tools. Due to methodological heterogeneity, no meta-analysis was conducted; instead, the findings were integrated through a narrative synthesis approach. Results: Evidence supports oxytocin’s modulatory effects on amygdala reactivity, prefrontal–limbic connectivity, and hypothalamic–pituitary–adrenal axis function. Intranasal oxytocin appears beneficial for emotional regulation and interpersonal sensitivity, particularly in individuals with early trauma. The reported effect sizes ranged from small (Cohen’s d ≈ 0.40) to large (d ≈ 0.83), though some trials reported null or adverse effects, such as increased hypermentalization. Heterogeneous responses were influenced by factors such as sex, trauma history, and OXTR gene variants. Con Intranasal oxytocin appears beneficial for emotional regulation and interpersonal sensitivity, particularly in individuals with early trauma. The reported effect sizes ranged from small (Cohen’s d ≈ 0.40) to large (d ≈ 0.83), though some trials reported null or adverse effects, such as increased hypermentalization. Heterogeneous responses were influenced by factors such as sex, trauma history, and OXTR gene variants. Conclusions: Although intranasal oxytocin shows promise in modulating core neurobiological systems implicated in BPD and enhancing emotion regulation and social cognition, its clinical effects remain variable and context-dependent. Sample characteristics (e.g., size, sex distribution, trauma history). Method and dosage of oxytocin administration (e.g., intranasal or endogenous measurement). Targeted outcomes (e.g., amygdala activity, prefrontal connectivity, cortisol levels, emotional regulation, and social cognition). Moderator variables (e.g., OXTR gene polymorphisms, psychiatric comorbidities). Key findings and, where reported, statistical effect sizes (e.g., Cohen’s d). Any discrepancies between reviewers during data extraction were resolved through discussion, with a third reviewer consulted when needed. Various studies demonstrate that, while oxytocin may enhance prosociality in some patients with BPD, it can exacerbate symptoms of hypermentalization and mistrust in patients who have experienced severe attachment trauma [ 23 , 35 , 36 , 41 , 50 , 57 , 58 , 59 ]. This suggests that the impact of oxytocin could depend on underlying neurobiological and psychological factors, heightening the need for tailored oxytocin-based interventions [ 23 , 60 , 61 ]. 3.5. Clinical Effectiveness of Intranasal Oxytocin 3.5.1. Oxytocin and Depressive Symptoms Importantly, there is no strong link between oxytocin concentrations and depressive symptoms. Intranasal oxytocin improves symptom severity in patients with major depressive disorder (MDD) lacking BPD, but has no effect on patients with comorbid BPD, revealing that its action varies based on patient characteristics [ 94 ]. Contradictory Results and Weaknesses Despite such positive results, the studies show contradictory findings. Some studies have suggested that oxytocin administration can exacerbate hypermentalization, causing individuals to misinterpret social cues and experience increased paranoia [ 23 , 41 , 76 , 95 , 96 ]. In terms of psychological function, oxytocin was associated with improvements in emotional regulation and social cognition, including reductions in rejection sensitivity and the enhanced interpretation of social functioning. However, these effects were moderated by trauma history and attachment patterns. Clinical trials produced mixed results: while some studies reported an improvement in symptoms, others identified adverse outcomes such as heightened hypermentalization or a lack of therapeutic benefit, particularly in participants with unresolved trauma. This suggests that the peptide’s prosocial effects may depend on developmental and relational factors. This bidirectional effect highlights the contextual and person-specific action, emphasizing the importance of tailoring interventions to patients’ trauma histories and relational patterns. These findings point to a promising, yet nuanced, translational pathway: while oxytocin can facilitate improved emotional and social processing in many individuals with BPD, its effectiveness may depend on concurrent psychotherapeutic support and careful patient selection. 4.4. Clinical Applications and Integration into Psychotherapy Evidence from randomized controlled trials assessing the therapeutic utility of intranasal oxytocin for BPD presents a complex picture. While several studies report improvements in emotion regulation, interpersonal trust, and symptom reduction, others fail to show significant benefits or even suggest adverse effects such as For instance, a trial at the University of Freiburg (NCT05285383) is examining the combined effects of oxytocin and psychotherapeutic training on emotion regulation in individuals with personality disorders. Another planned study in Israel (NCT05465753) is investigating oxytocin-enhanced psychotherapy in female patients with trauma histories and interpersonal dysfunction. These trials reflect a growing interest in developing integrative treatment models that tailor oxytocin use to specific therapeutic contexts and patient characteristics.

Brief psychotherapy for posttraumatic stress disorders. A large-scale study of the effectiveness of psychotherapeutic methods for the treatment of posttraumatic stress disorders was conducted. The sample consisted of 112 persons suffering from serious disorders resulting from traumatic events (bereavement, acts of violence, and traffic accidents) that had taken place not more than 5 years before. Trauma desensitization, hypnotherapy, and psychodynamic therapy were tested for their effectiveness in comparison with a waiting-list control group. The results indicated that treated cases were significantly lower in trauma-related symptoms than the control group. Published in Journal of consulting and clinical psychology (1989)