Extreme weather-related knowledge level and educational needs among medical students: a multi-city cross-sectional study in eastern China.

Randomised controlled trials (RCTs) and recent meta-analyses show large short-term antidepressant effects of psilocybin compared to control conditions. Evidence derives mostly from studies in highly selected populations and under tightly standardised protocols. Generalisability to routine care and to complex treatment-resistant populations remains uncertain. Given the distinctive features of psychedelic interventions and related methodological challenges, real-world evidence is an important complement to RCTs. Real-world studies remain scarce, based on small, heterogeneous samples that often mix indications (e.g. cancer-related distress and major depression) or different substances and usually provide limited session-wise outcome data. We searched MEDLINE/PubMed, Embase, Cochrane Library, and for reports on psilocybin from 2000 to Nov 30, 2025, without language restrictions, using combinations of terms for the intervention and indication (e.g., “psilocybin”, “psychedelic”, “depression”, “major depressive disorder”, “treatment-resistant depression”, “TRD”, “real-world”, “compassionate use”). We also screened reference lists of key articles, recent conference proceedings, and preprint servers for additional studies. This retrospective longitudinal observational analysis provides, to our knowledge, some of the first systematically collected real-world data on psilocybin treatment for treatment-resistant depression delivered under a regulated clinical framework. It reports clinician-rated and self-reported outcomes, uses mixed-effects modelling to examine session-wise change across up to four dosing sessions, and documents safety under routine conditions. We observed a reduction in depressive symptoms after the first dosing session that was largely maintained with subsequent sessions, no serious or sustained adverse events documented in the medical record, and response/remission rates that were lower than those in several controlled trials.