Major depressive disorder's high heterogeneity makes broad treatments difficult. Focusing on single, biologically understood core symptoms may be more viable. The Research Domain Criteria framework offers a trans-diagnostic dimensional approach. Psychedelics show potential antidepressant activity, possibly explained through multi-level analysis of cognitive systems. Cognitive deficits like negative emotional processing and negativity bias lead to depressive rumination. Psychedelics increase long-term cognitive flexibility, normalizing negativity bias and reducing rumination.
A theoretical framework is proposed to distinguish the hallucinogenic effects of psychedelics from their antidepressant effects. The authors argue that hallucinations and mood improvement may arise through separable neural mechanisms, and they outline a translational approach—spanning cellular, circuit, and behavioral levels—to test this dissociation. The framework suggests that antidepressant benefits could be achieved without the hallucinatory side effects, potentially leading to safer treatments. The paper synthesizes evidence from preclinical and clinical studies to support the idea that the two phenomena are not inevitably linked, though it acknowledges that further research is needed to confirm this separation.