The role of non-ordinary states of consciousness occasioned by mind-body practices in mental health illness.

BACKGROUND: Research with hallucinogens suggests that non-ordinary states of consciousness (NOSCs), particularly mystical-type experiences, predict improvements in various affective disorders and substance use disorders (SUDs). Little is known, however, about the therapeutic potential of NOSCs induced by mind-body practices such as meditation, yoga and breathwork. METHODS: We conducted a literature review in online databases (PubMed, Scopus, Google Scholar) and preprint databases (SSRN, bioRxiv) to identify studies of NOSCs induced by mind-body practices and their effects in affective disorders and SUDs. RESULTS: A wide variety of mind-body practices involving physical movement (i.e., shamanic drumming, yoga) and deliberate immersive experiences (i.e., meditation, breathwork) have been reported in the literature. Preliminary evidence, mostly from qualitative studies and open label studies, suggest that mind-body practices produce NOSCs. These experiences have also been correlated with short-term reductions in anxiety and depression, with increased motivation to change addictive behaviors, and with enhanced self-awareness and well-being. LIMITATIONS: Findings are limited by the scarcity of literature in this field. Further rigorous and methodologically sound empirical research is needed, including comparative studies of NOSCs occasioned by different methods. CONCLUSIONS: Mind-body practices may represent a promising approach for treating mental health disorders. The NOSCs induced by such practices may lead to beneficial shifts in perceptions, values, beliefs, and behaviors. Given the challenges with hallucinogen-based therapies, mind-body practices may represent a more accessible and acceptable way of eliciting potentially helpful NOSCs in clinical practice.

Uso de pacientes simulados en psiquiatría / Use of Simulated Pacients in Psychiatry

Introducción: Los avances científicos y la complejidad del conocimiento humano generan una constante necesidad de crear nuevas herramientas que faciliten el aprendizaje de una forma amena y duradera. En la docencia médica, una de estas herramientas es el uso de pacientes simulados. Los pacientes simulados o estandarizados son actores o personas entrenadas rigorosamente para presentar una historia clínica o, de ser posible, hallazgos físicos específicos, con la finalidad de ser un complemento educativo y evaluativo de la práctica clínica. Específicamente en psiquiatría, el uso de pacientes simulados ha tenido en general una gran acogida; sin embargo, se cuestiona su utilidad en áreas como la psicoterapia o la evaluación de residentes. Métodos: Revisión a partir de la búsqueda en PubMed con los términos MESH: ("Psychiatry/education" y "Patient Simulation"); búsqueda en LILACS y Schoolar Google, utilizando términos similares. Resultados: Los pacientes simulados son ampliamente usados alrededor del mundo en el área de psiquiatría; su utilidad como herramienta de enseñanza a estudiantes de pregrado se confirma en la mayoría de literatura revisada. Uno de los principales beneficios del uso de estos pacientes es la adquisición de habilidades específicas (por ejemplo, toma correcta de la historia clínica); no obstante, hay opiniones encontradas en cuanto a su efectividad en experiencias más complejas, como la psicoterapia o la certificación de residencia. Conclusiones: A pesar de la controversia, la gran mayoría de la literatura revisada confirma los beneficios y la aceptación que ha tenido esta metodología en la formación de estudiantes y psiquiatras.

Introduction: Scientific advances and the complexity of human knowledge generate a constant need for creating new tools intended to facilitate learning in an agreeable and lasting form. Simulated patients are one of such tools in medical education. Standardized or simulated patients are actors or people vigorously trained to represent a medical history or, if possible, specific physical findings with the purpose of using such representations as an educational and evaluating supplement in clinic practice. The use of simulated patients has been very well received, particularly in the psychiatric field; however, its usefulness in areas such as psychotherapy or evaluation of residents remains questionable. Methods: A search was made in PubMed with the MESH words ("Psychiatry/education" and "Patient Simulation"); a search was also made in LILACS and scholar Google using similar words. Results: Simulated patients are widely used throughout the world in the psychiatry field and their usefulness as an academic tool for pre-graduate students is confirmed in most of the literature reviewed. One of the main benefits of the use of this kind of patients is the acquisition of specific abilities (e.g.: medical history recording); nevertheless, its efficacy in more complex experiences like psychotherapy or certification of psychiatry residents is questioned. Conclusions: Notwithstanding the controversy, most of the literature reviewed confirms the benefits and acceptance of this methodology in the formation of students and psychiatrists.