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It was a real privilege to be invited to present on treatment-resistance in anxiety disorders at the Psychiatry Masterclass 2025 at the Conrad Dubai. Many thanks to the organising and scientific committees for inviting me!
It was great to be there with such excellent speakers!
Excellent @liviaasan.bsky.social, well done!
Our new Insights article out now in European Neuropsychopharmacology
We argue that poor control conditions in digital therapeutics trials risk misleading efficacy claims.
Let’s raise the bar for DTx trial design.
🔗 authors.elsevier.com/a/1l-8p,L21E...
@ecnp.eu
#DTx #MentalHealth #ClinicalTrials
It was great to present on placebo and nocebo effects in depressive and anxiety disorders in an educational update session at the ECNP Congress. Many thanks to the educational committee for inviting me! @ecnp.eu
🎥 Two new #SFB289 #webinars are uploaded on our YouTube channel! 🎥
In September 2025, @nathanhuneke.bsky.social presented his work on placebo effects in psychiatric disorders: youtu.be/Z1pyhXSV5RE
Great to collaborate on this with @hvansteenbergen.bsky.social! We found evidence that endogenous opioids mediate attentional broadening after receiving rewards.
Really enjoyed the opportunity to present at the SFB289 webinar!
Great to be part of this
Our new study published in TheLancetPsych! We found that pramipexole augmentation substantially reduced depressive symptoms in patients with treatment-resistant depression over 48 weeks of treatment. This is an important advance in how we treat depression! 1/6
www.thelancet.com/journals/lan...
Timely article!
Our thoughts on missing data, statistics and placebo effects in psychiatric trials.
Thanks Samuele Cortese and Marco Solmi!
jamanetwork.com/journals/jam...
Very important initiative!
Our new review in JAMA Psychiatry: "Expectancy Effects, Failure of Blinding Integrity, and Placebo Response in Trials of Treatments for Psychiatric Disorders"
jamanetwork.com/journals/jam...
Thanks to co-first author Guil Fusetto-Veronesi; and to Samuele Cortese, David Baldwin, Matt Garner
🧵👇
Check out the paper and let us know what you think!
jamanetwork.com/journals/jam...
3. We should develop readouts that are resistant to expectation effects (e.g. psychophysics, network connectivity). Experimental medicine models appear resistant to expectation effects, & could be used to develop such readouts academic.oup.com/ijnp/article... journals.sagepub.com/doi/abs/10.1...
2. Statistical methods to 'account for' or 'correct for' expectation effects in RCTs exist but need testing and validating. Gathering data as in recommendation 1 would allow us to do this.
We make the following recommendations:
1. We should systematically record blinding integrity for patients and for clinician raters, and if it fails, why. This would allow us to explore the above question.
If blinding fails in active arms in RCTs w/ larger drug-placebo separation, that might be OK, as an effective treatment might unblinds patients/raters. BUT, if blinding failure in placebo arms drives the difference (maybe through 'disappointment'/'know'-cebo/'lessebo') then that would be a concern.
Our recent work shows blinding integrity is rarely measured in psychiatric RCT's. Yet, signals suggest a potential relationship between functional unblinding and greater drug-placebo separation - perhaps due to lower placebo effect onlinelibrary.wiley.com/doi/full/10.... jaacap.org/article/S089...
i.e. higher expectations = higher treatment efficacy. Treatment effects are larger in open-label trials compared with the same treatment given double-blind. Despite this, effect of functional unblinding on estimates of efficacy has been little explored, partly due to lack of data
'Response to treatment' results from 3 broad effects: non-specific effects, placebo-specific effects (expectations, associative learning, maybe unblinding effects...), and the improvement specifically attributable to the treatment itself. These effects appear to be additive:
In this narrative review we discuss how expectancy effects and functional unblinding can impact treatment and placebo responses in RCT's treatments in psychiatry.
We finish with recommendations for the field. Here is a summary:
Our new review in JAMA Psychiatry: "Expectancy Effects, Failure of Blinding Integrity, and Placebo Response in Trials of Treatments for Psychiatric Disorders"
jamanetwork.com/journals/jam...
Thanks to co-first author Guil Fusetto-Veronesi; and to Samuele Cortese, David Baldwin, Matt Garner
🧵👇
🧠 Help Us Understand Pain Perception in FND! 🧠
Looking for volunteers with & without #FND for a study in London @kingsioppn.bsky.social. Single lab visit testing pain perception with electrical stimulation.
Interested? Please message me: Livia.Asan@kcl.ac.uk ✉️
Thanks for sharing!
Of course!
Why academia is sleepwalking into self-destruction. My editorial @brain1878.bsky.social If you agree with the sentiments please repost. It's important for all our sakes to stop the madness
academic.oup.com/brain/articl...
