Skip to content

Curation log — post-traumatic stress disorder

Newest entries first. Every content-changing session appends an entry: date, what changed, what was searched, follow-ups for next time. See CLAUDE.md.

2026-09-02 — Seeded (Claude)

Created the scaffold: INDEX.md with a 22-page plan (20 topical + 2 standing house pages) and a 12-record anchor table, a seed OPEN-QUESTIONS.md, this log, and the empty wiki/ and literature/ layers. No wiki pages written.

Searches run (live PubMed E-utilities, 2026-09-02). Scoping: post-traumatic stress disorder 60,888; stress disorders, post-traumatic[MeSH Major Topic] 41,226. Per-page topic counts in INDEX.md, including epidemiology 19,588, children/adolescents 6,527, complex PTSD/ICD-11 4,283, military/veterans 3,936, cognitive processing therapy 3,810, prolonged exposure 1,023, comorbidity 923, EMDR 874, dropout/attrition 870, SSRI 664, moral injury 553, prazosin 129, MDMA 129, ketamine/psychedelic 80.

Query-hygiene note. Three initial queries returned implausible numbers through loose automatic term mapping — post-traumatic stress disorder AND moral injury returned 54,812, close to the entire PTSD literature, because "injury" mapped to a very broad term. Re-run as a quoted phrase it returns 553. Affected counts are marked † in INDEX.md. An unchecked count here would have justified a page size the literature does not support.

Anchor records resolved live: 12, listed in INDEX.md.

Scoping decisions. Three borders. The condition owns the disorder, not trauma exposure in general, whose literature is far larger. Comorbid depression and substance use are cross-linked to depression and generalized-anxiety-disorder rather than absorbed. Complex PTSD is in scope and presented as an unresolved nosological dispute, because the DSM-5/ICD-11 divergence changes who is diagnosed and which trials apply to them.

Currency warning written into the seed. Two areas move faster than a seed can hold. The MDMA-assisted therapy phase 3 papers (PMID 33972795, 37709999) report trial results and not the subsequent regulatory outcome; the builder must establish current regulatory and replication status by live search, including registry and regulatory sources, and record the search date. Do not infer a regulatory outcome from a trial result. The same applies to the ketamine and psychedelic literature. Separately, prazosin's positive early trials (PMID 12562588, 17069768) were followed by later re-testing that is not among the anchors and must be retrieved.

Flagged for the build pass. No anchor yet for ISTSS/VA-DoD/NICE guidelines, SSRI regulatory trials, criterion-A and instrument validation, moral-injury primary sources, early pharmacological prevention, or patient-organisation material.

Follow-ups. Build with tools/build-condition.sh ptsd; auditor must differ from the writer.

2026-09-02 — Full build (Codex)

Built all 22 canonical PTSD wiki pages at draft status; created a 345-record bibliography, 6 landmark notes, international guideline registry, statistics sheet, four-file patient-voice layer, 15-question research agenda and updated index. Pages explicitly separate DSM-5 PTSD, ICD-11 PTSD and CPTSD; mixed-anxiety estimates are labelled and only PTSD strata are used; GAD and depression are cross-linked rather than absorbed.

Live PubMed searches. Re-verified all seed anchors and searched diagnosis/CAPS-5/PCL-5/ITQ, CPTSD, epidemiology/risk, neurobiology/fear extinction/HPA/memory, PE, CPT, EMDR, comparative psychotherapy, dropout/nonresponse, pharmacotherapy/SSRIs/SNRI, prazosin/nightmares/IRT, MDMA/psychedelics/ketamine, early intervention/debriefing/hydrocortisone/propranolol, veterans, pediatrics, comorbidity, moral injury, guidelines, suicide/safety and qualitative/preferences. EFetch resolved 360 records; 345 unique records were retained after removing non-specific search hits.

Key corrections to the seed. Retrieved the later prazosin re-test (PMID 29414272). Established current MDMA status from a live-retrieved 2025 review: FDA rejected the initial 2024 NDA and required another phase 3 trial (PMID 39741438); positive phase 3 results were not treated as approval.

2026-09-02 — Registry, policy and patient-source verification (Codex)

Queried ClinicalTrials.gov v2 live for PTSD and individually re-fetched 11 retained NCT records: NCT03537014, NCT04077437, NCT04959695, NCT04560660, NCT06795659, NCT06549049, NCT05341882, NCT04007666, NCT03711266, NCT05560854 and NCT07430657. Excluded broad condition-query records where PTSD was only an incidental outcome.

Fetched official VA/DoD 2023, APA 2025, NICE NG116, ISTSS 2018, Phoenix Australia/RANZCP and WHO guideline pages. Verified nine public organizations/resources; patient themes use public or PubMed-indexed sources only, are aggregate paraphrases, and retain no private identities.

Follow-up for independent audit. Re-fetch every cited PMID and NCT; check article–claim fit and exact metadata; inspect full texts where abstracts do not support nuance; audit registry–publication concordance; validate all relative links; leave unresolved pages draft.

2026-09-02 — Independent audit (Claude; author was Codex)

Auditor: Claude. Author of the material audited: Codex (build entry above). A different engine wrote every page checked here; no model audited its own writing.

Scope of checking

Object Count checked
Unique PMIDs re-fetched live (esummary + efetch) 385 (345 as built, 40 added during the audit)
Reference-list lines checked against the live record (title, journal, year, volume, pages) 659
Evidence-ledger rows checked against the live record 655
Inline claim→citation pairs read against the source text 571 instances across 22 pages, plus every numeric claim traced to the abstract that states it
NCT IDs re-fetched individually from the ClinicalTrials.gov v2 API 15 (11 as built, 4 added)
Landmark notes re-checked figure by figure 6
Patient-voice organization URLs re-fetched 9 (7 returned HTTP 200 with a matching title)
Guideline issuing-body pages re-fetched 3 attempted

Every one of the 385 PMIDs resolved, and every one matched the author, year, journal and title it was cited under. No fabricated or misattributed identifier was found anywhere in the condition — the build's citation hygiene at the identifier level was clean. The errors were all of a different kind: real records attached to claims they do not support.

Errors found and fixed

A. Claim–citation mismatches (real record, wrong claim). Fourteen citations supported claims their papers do not make. All were corrected by re-anchoring the claim to a live-retrieved source that does support it, and by stating the number the source actually reports.

Page Claim What was cited Fix
cognitive-processing-therapy.md "Telehealth and massed formats can reduce travel or duration…" PMID 35187740 (mindfulness for nurses' burnout) and PMID 30388297 (Cochrane review of ICU follow-up services) Replaced with four CPT-specific delivery trials: Morland 2015 (PMID 26243685), Peterson 2022 (PMID 35038985), Held 2022 (PMID 35338534), Bruce 2025 (PMID 38946118); both wrong records removed from the page
emdr.md "Working-memory loading predicts reduced vividness/emotionality" PMID 32043428 (EMDR efficacy meta-analysis) and PMID 27726123 (Cochrane pediatric psychological therapies) Replaced with the two dismantling syntheses that measure this: Lee 2013 (PMID 23266601, d=0.41 clinical / 0.74 laboratory) and Mertens 2021 (PMID 34619553, k=53). The two displaced records were moved to sections they do support, with their real numbers
pharmacotherapy.md "Class labels should not imply equal evidence for every molecule" PMID 10761678 (psychosocial treatment review) and PMID 31672337 (cannabinoid meta-analysis) Replaced with the Cochrane pharmacotherapy numbers (PMID 35234292); the cannabinoid review moved to the emerging-agents section where it belongs
pharmacotherapy.md "A negative or small augmentation trial cannot be rescued by a class effect" PMID 38647566 (music therapy meta-analysis) Replaced with Hamner 2019 ziprasidone augmentation RCT (PMID 30640209), retaining Davis 2025 (PMID 39693081)
sleep-and-nightmare-treatment.md "IRT rescripts recurrent nightmares…protocols differ" PMID 25036580 and PMID 24612528 (both prazosin/general PTSD reviews) Replaced with Krakow 2001 (PMID 11476655) and Yücel 2020 (PMID 31855732); the two prazosin reviews re-sited in the prazosin section, where they now document a genuine disagreement with the null trial
sleep-and-nightmare-treatment.md "Trials should measure both sleep and PTSD" PMID 27432823 (prazosin review) Replaced with the two sequencing RCTs: Pigeon 2022 (PMID 34265777) and Colvonen 2025 (PMID 40488726)
dropout-and-nonresponse.md "Session-level change, alliance and avoidance…" PMID 29252162 (mindfulness review) and PMID 29169664 (long-term efficacy meta-analysis) Replaced with Wright 2024 IPD meta-analysis (PMID 39537555) and Maglione 2022 (PMID 34800059)
epidemiology-and-risk.md "Prospective cohorts with pre-trauma measurement…" PMID 29869691 (ambulance-personnel prevalence) Replaced with two actual pre-trauma cohorts: Acheson 2025 (PMID 41103636, n=643) and de Voogd 2025 (PMID 40024495, n=221); the ambulance review moved to the occupational-populations section with its real 11% figure
epidemiology-and-risk.md "Occupational populations should not be used as generic civilian estimates" PMIDs 30422749 and 29609900 (both older-adult/geriatric papers) Re-anchored to Petrie 2018 (PMID 29869691); the geriatric papers now support the age-band claim they actually address
red-flags-and-safety-concerns.md "Adult medication approvals cannot be imported [to children]" PMID 39630422 (pediatric psychotherapy NMA — says nothing about drug approvals) Replaced with the NICE pediatric pharmacological evidence review (PMID 32757557) and Stoddard 2011 (PMID 22040192)
patient-experience-and-advocacy.md "Telehealth helps some barriers and creates privacy/digital-access barriers" PMID 35898808 (self-stigma prevalence) Replaced with Bruce 2025 (PMID 38946118); the self-stigma paper now supports an accurately stated stigma claim
literature/patient-voice/themes.md "Practical access" and "digital care trade-offs" themes Both rested on PMID 35898808 (self-stigma) Re-anchored to PMID 39295155 and PMID 38946118; a separate, correctly stated stigma theme added so the displaced source is used for what it shows
early-intervention-and-prevention.md "Small heterogeneous trials do not establish routine prevention" PMIDs 36402246 and 26808441 (both preclinical/mechanistic reviews) Kept as mechanism citations and added the actual trial synthesis: Astill Wright 2019 (PMID 31819037), 19 RCTs, hydrocortisone RR 0.21 (95% CI 0.05–0.89), everything else null
prolonged-exposure.md "Inhibitory learning, expectancy violation… are competing models" PMIDs 16891563 and 16919525 (2006 neuroimaging reviews) Added Craske 2014 (PMID 24864005), the source that states the model; the imaging reviews re-scoped to the circuitry claim they support

B. Stale absences (the failure mode this audit is designed to catch). Three asserted absences were re-searched live and two had gone stale.

  1. Psilocybin. mdma-and-psychedelic-assisted-therapy.md carried a 2022 review's statement that no psilocybin PTSD trial had been conducted (PMID 35711024). Re-running the search on 2026-09-02 found two published PTSD trials: McGowan 2026 (PMID 40883964; phase 2, non-randomized, open-label, n=22, CAPS-5 −29.9 at week 4) and Armstrong 2026 (PMID 42533157; open-label veteran pilot, n=12, −27.5 points, 95% CI 19.9–35.1, NCT05554094). Rewritten as a dated, positively-stated gap: as of 2026-09-02, 34 participants across two single-arm studies and no randomized controlled psilocybin PTSD trial published.
  2. Prazosin responder phenotype. The build (and OQ-4) treated the responder question as untested. Live searching found the candidate marker — pretreatment standing systolic blood pressure, +14-point CAPS reduction per 10 mm Hg under prazosin (Raskind 2016, PMID 27320368), contested by Manhapra 2019 (PMID 30143236) — and a live registry check found NCT03539614, a phase 3 prazosin-versus-placebo trial built around noradrenergic biomarkers (n=87), with an actual primary completion date of 1 January 2026 and no results publication indexed in PubMed. The gap is now stated as "complete but unreported", not "untested".
  3. ITQ-stratified CPTSD trials. complex-ptsd.md said "trials rarely stratify by ITQ-defined CPTSD". Still broadly true, but a live search found the RESTORE pilot RCT (Karatzias 2024, PMID 38688242) and a moderator analysis (Hoeboer 2021, PMID 33831660) in which CPTSD status neither predicted nor moderated exposure-therapy outcome. Restated precisely: a pilot against usual care exists; the comparison against active trauma-focused therapy in ITQ-defined CPTSD has not been run.

C. Currency corrections.

  • Ketamine. Both pharmacotherapy.md and the MDMA page asserted only that "ketamine evidence for depression is not PTSD evidence", while PTSD-specific randomized evidence exists and disagrees with itself. Added Feder 2021 (PMID 33397139; n=30, CAPS-5 −11.88, d=1.13) and Abdallah 2022 (PMID 35046508; n=158, null on PCL-5 and CAPS-5) side by side, with the population and dosing differences stated rather than averaged.
  • MDMA regulatory status. "A 2025 review reports the FDA rejected the initial 2024 application" is now dated to the decision itself (declined August 2024) and corroborated by a second 2026 review (Morland 2026, PMID 41820235), with a 2026 meta-analysis of 8 RCTs added (Fares-Otero 2026, PMID 41825162; SMD −1.19, 95% CI −1.95 to −0.42, most trials at high risk of bias in outcome measurement).
  • New drug class. The TSND-201 (methylone) phase 2 RCT (Jones 2026, PMID 41706459, NCT05741710) had reported since the build and is the only PTSD drug trial in this base that separates a rapid-acting drug effect from a therapy package; added to pharmacotherapy, MDMA and trials pages and made the basis of new question OQ-17.
  • NICE NG116. The registry recorded the April 2025 surveillance as current. A live re-fetch of the NG116 evidence page found a July 2026 exceptional surveillance listed as well. Its decision document returned HTTP 403, so the outcome is recorded as unresolved rather than assumed.
  • Harper 2026 direction. The build cited the CPT-versus-PE dropout trial four times without ever stating its result. The direction (PE 52.31% vs CPT 45.77%, separating after session 3) is now given on all five pages that use it.

D. Overstatements softened. Three claims went beyond their sources and were rewritten to what the source shows: the "diagnostic labels may feel reductive" claim on patient-experience-and-advocacy.md (Beck 2016 is a metaphor analysis; Benfer 2023 is a conceptual Open Forum — both now described as such); the moral-injury treatment-comparison claim, where Dobos 2023 (PMID 36630050) is a bioethics argument with no PubMed abstract and is now labelled as an ethical argument rather than evidence of effect; and the blinding claim on the MDMA page, moved from a two-page JAMA Viewpoint to the 2026 state-of-the-science review that enumerates the five methodological debts.

E. Metadata. One reference and one ledger row carried the literal placeholder "[Not Available]" as the title of PMID 37615227 (a Danish-language review); replaced with the record's actual English title.

Searches re-run during the audit (live PubMed E-utilities and ClinicalTrials.gov v2, 2026-09-02)

Psilocybin × PTSD (all designs, and restricted to RCTs); MDMA-assisted therapy 2025–2026; ketamine × PTSD randomized trials; imagery rehearsal therapy and CBT-I for trauma-related nightmares; prazosin responder/predictor/biomarker (plus a registry sweep of all prazosin × PTSD studies); CPT telehealth and massed formats; massed and intensive-outpatient PE; PTSD dropout predictors and attrition meta-analyses; sertraline/paroxetine placebo-controlled PTSD trials; pediatric PTSD pharmacotherapy; ITQ/CPTSD randomized trials; eye-movement dismantling and dual-task working-memory studies; pre-trauma and pre-deployment prospective cohorts; inhibitory-learning exposure literature; PTSD × SUD psychological interventions; telehealth acceptability and barriers; VA/DoD 2023 guideline synopsis. Individually re-fetched NCT03537014, NCT03539614, NCT03711266, NCT04007666, NCT04077437, NCT04560660, NCT04959695, NCT05341882, NCT05554094, NCT05560854, NCT05741710, NCT06549049, NCT06795659, NCT07430657 and NCT00532493.

Content added because the audit exposed a hole, not because it was asked for

  • epidemiology-and-risk.md had no population prevalence figure at all. Added US lifetime 6.1–8.3% and global 3.9% (Flesaker 2026, PMID 42089634), plus perinatal community-versus-high-risk strata that demonstrate the denominator problem the page argues for.
  • pharmacotherapy.md had no quantitative SSRI effect. Added the Cochrane numbers (66 RCTs, n=7,442; response RR 0.66, 95% CI 0.59–0.74; withdrawal RR 1.41, 95% CI 1.07–1.87) and the PE-versus-sertraline head-to-head (PMID 30516797).
  • clinical-trials-landscape.md listed registry status without enrollment, concealing that a "completed" esketamine-plus-PE study (NCT06795659) enrolled 4 participants. The table now carries phase and enrollment for all 14 trials.
  • comorbidity.md asserted that integrated and sequential SUD approaches "should be compared" without citing the comparisons that exist (PMID 37971855; PMID 35558682).
  • children-and-adolescents.md had an uncited Medication section and no acceptability data; both now sourced (PMID 32757557, PMID 22040192, PMID 34377359 — pediatric dropout 11.7%, notably lower than the adult figures).

Promotion result

21 of 22 pages promoted to status: curated. Every citation on those pages resolves, matches its record, and supports the claim it is attached to; every quantitative claim was traced to the source text; every asserted absence was re-run and re-dated.

guidelines.md remains draft, for a reason specific to it: three of its load-bearing facts rest on issuing-body web pages rather than PubMed records, and those could not be independently re-verified from this session. healthquality.va.gov failed at the TLS layer; istss.org returned HTTP 200 but renders its content client-side, so the 361-RCT / 208-meta-analysis / 125-recommendation counts could not be read from the raw HTML and remain as the build session recorded them. The VA/DoD guideline itself has been re-anchored to its peer-reviewed synopsis (Schnurr 2024, PMID 38408360), which independently confirms the 34-recommendation figure and the GRADE/PICOTS process, so that claim is now solid. The residual uncertainty is the ISTSS counts and the unknown outcome of NICE's July 2026 exceptional surveillance. literature/guidelines/REGISTRY.md is likewise held at draft and carries both notes inline.

Still flagged for the next sweep

  1. NICE NG116 July 2026 exceptional surveillance — retrieve the decision document. Highest priority; it may change a first-line recommendation.
  2. NCT03539614 — completed 1 January 2026, unpublished. Its result decides OQ-4 (prazosin responder phenotype) and either resolves or entrenches the prazosin contradiction.
  3. ISTSS 2018 counts — re-verify from a source that is not client-rendered, or replace with a PubMed-indexed equivalent.
  4. Two organization URLs — combatstress.org.uk (HTTP 403, Cloudflare) and the canada.ca PTSD portal (HTTP/2 failure) could not be re-fetched; neither non-response is evidence the resource has changed.
  5. APA 2025, Phoenix Australia, RANZCP and WHO registry entries were not re-fetched in this audit; they were verified only by the build session.
  6. Structural note for whoever next builds a condition. Roughly 60% of each page's line count is boilerplate repeated verbatim across all 22 pages (the "Minimum extraction frame", "Claims this page does not make" and "Evidence-updating triggers" tables), and most pages' citation counts are carried by an Evidence-ledger table that restates each record's title rather than making a claim about it. Median inline-cited records per page is 10 against 30 reference lines. The citations are real and the ledgers are accurate — this is a density problem, not an integrity problem — but a future build should spend those lines on content instead.

2026-10-09 — Literature sweep (Claude)

Author: Claude (claude-opus-5-5). This is the first periodic sweep since the 2026-09-02 build (Codex) and audit (Claude). Every page this sweep edited has been demoted to draft. A different engine must audit it, because this entry's author also wrote those edits.

Window and method. Publication window 2026-09-02 → 2026-10-09 by Entrez date. I ran 26 PubMed E-utilities topic searches, one per wiki-page topic plus RCT, systematic-review, guideline and Cochrane filters, and screened 495 unique PMIDs by title. About 25 abstracts were read, and 18 in-window records survived triage. The query strings, PubMed translations and every returned PMID are in literature/sweeps/2026-10-09.json. The PubMed MCP connector was disconnected for this session, so all PubMed access went directly through E-utilities.

Sources actually queried.

Source Queried Notes
PubMed yes 26 window searches and 8 targeted all-date searches
Cochrane, via "Cochrane Database Syst Rev"[jour] yes Window and 2024–2026
Europe PMC yes 411 non-MEDLINE records, mostly Eur Psychiatry congress abstracts, plus 57 preprints. None survived triage. Also used for full-text availability.
Crossref yes Retraction (updated-by) check on every added record
ClinicalTrials.gov v2 yes All 15 cited NCTs re-fetched; sweeps for psilocybin, MDMA, prazosin, new results and new phase 2/3 registrations
ISRCTN API yes —
EU CTIS yes Public search returned 0 records
NICE yes —
WHO ICTRP no JS portal, not programmatically usable
Cochrane Library / CENTRAL no HTTP 403
SciELO / LILACS no HTTP 403
Unpaywall skipped LIFEBANK_CONTACT_EMAIL unset, so no email was sent to Crossref either

Absences below are stated per source.

What was found, in order of importance

  1. Three MDMA papers retracted and two under expression of concern; this condition had never noted it. The Green 2026 abstract mentioned "recent article retractions", which prompted a targeted search. It found three sponsor-authored pooled phase 2 analyses in Psychopharmacology, retracted in November 2024 (PMIDs 31065731, 32500209, 33221932; notices 39126501/500/502). I read one notice in full from PMC. It cites "protocol violations amounting to unethical conduct at the MP4 study site" that the authors knew of and did not disclose. Two J Trauma Stress secondary analyses carry expressions of concern (PMIDs 32073177, 34114250); their texts are PDF-only, so the grounds were not read. None of these was cited in this condition. I then re-checked all 385 previously cited PMIDs for retraction and EoC flags in PubMed (publication types plus CommentsCorrections), and none carries one. MAPP2 (PMID 37709999) has a correction (PMID 39375459), not a retraction. → mdma-and-psychedelic-assisted-therapy.md, INDEX five-sentence summary, OQ-5, STATISTICS, BIBLIOGRAPHY (documented, not cited as evidence).
  2. A new Cochrane pharmacotherapy version, with no new evidence. CD002795.pub4 (Williams 2026, PMID 42206608) was published 28 May 2026, and Crossref marks it as the new_version of the 2022 review this wiki cites. Its abstract reports identical numbers and states that "the date of the latest search was 13 November 2020". The wiki's SSRI figures therefore stand, but the current Cochrane estimate contains no trial after November 2020: no Abdallah 2022, no Davis 2025, no TSND-201. What the version changed could not be read. PMC is embargoed, Europe PMC has no free full text, and cochranelibrary.com returns 403. → pharmacotherapy.md, STATISTICS.
  3. A 2024 Cochrane review contradicts the hydrocortisone claim and had been missed by build and audit. Bertolini 2024 (PMID 38767196), restricted to adults with acute symptoms, gives hydrocortisone RR 0.47 (95% CI 0.09–2.38; 3 studies, n=136; very low certainty). The page asserted only Astill Wright 2019's RR 0.21 (n=88, severely medically ill). Both estimates are now presented side by side, not averaged. The included-trial lists could not be compared, because the Cochrane full text is unreachable and PMC holds the abstract only. → early-intervention-and-prevention.md, OQ-6 sharpened, new dot D21, STATISTICS caveat 13.
  4. NICE NG116 July 2026 exceptional surveillance: resolved, no update. This was follow-up #1 from the audit. The HTML decision page was retrieved live: the scope was adapted trauma-focused treatment for autistic people and people with ADHD, and the decision was "We will not update any of the NICE guidelines". → guidelines.md, REGISTRY.
  5. ISTSS 2018 counts: resolved. This was follow-up #3. All counts are confirmed by the PubMed-indexed methodology paper (Bisson 2019, PMID 31283056). The guidelines page was held at draft for exactly these two reasons (items 4 and 5), and both are now closed. I did not promote it. The auditor may.
  6. Registry changes.
  7. NCT04560660 (ketamine-enhanced PE) posted results on 2026-07-15, which the audit had not recorded. Week-22 CAPS-5 was 18.8 against 19.0 for midazolam, with no analysis posted, 34 of 73 not completing, and no publication.
  8. NCT03539614 (prazosin biomarker) is still unreported, with no change since 2026-08-14 and no PubMed record. Audit follow-up #2 remains open.
  9. TSND-201 phase 3 was registered on 2026-09-23 (NCT07836647, n=300).
  10. Randomized psilocybin PTSD trials are now registered (NCT07570654 n=300; NCT06853912; NCT06885996; NCT06407635). PubMed still has no published randomized psilocybin PTSD trial. ISRCTN and EU CTIS had none, and ICTRP was not checked.
  11. The protocol paper for NCT06608277 states n=210, but the registry says 175. Recorded, not resolved.
  12. → clinical-trials-landscape.md, pharmacotherapy.md, MDMA page, OQ-4/16/17, D4/D16/D17.
  13. Smaller additions (one to three sentences each):
  14. 5-year PE-A follow-up, LMIC, task-shifted (PMID 42734593) and child CBT-vs-EMDR meta-analysis, 5 RCTs, inconclusive (PMID 42831259) → children.
  15. LMIC Bayesian meta-analysis, 55 RCTs, with the SciELO/LILACS limitation stated (PMID 42750363), and PE-vs-CPT meta-regression (PMID 42712180) → comparative psychotherapy.
  16. Routine-care dropout: Fukushima cohort (PMID 42780894), stepped-care RCT (PMID 42832930), naturalistic PE (PMID 42766476) → dropout, OQ-1.
  17. AUD prevalence in PTSD, 35.6% lifetime (PMID 42745626) → comorbidity.
  18. Ketamine systematic review (PMID 42846850) and the Cochrane rTMS review, SMD −0.14, missed by build and audit (PMID 39092744) → pharmacotherapy.
  19. MDMA-bCBCT pilot (PMID 42693902) and single-sponsor MDMA meta-analysis (PMID 42708350) → MDMA page.
  20. Eight-country screening prevalence (PMID 42731553) and PTSD–stroke HR 1.50 (PMID 42767516) → STATISTICS only.
  21. The Cochrane child-PTSD and ongoing-conflict protocols (PMIDs 40326577, 42522780) and an EMDR meta-analysis whose abstract gives no numbers (PMID 42773467) → bibliography only.

Triaged out. The remaining ~470 window records, mostly cross-sectional, mechanistic, occupational moral-distress or non-PTSD-directed. Also out: two medRxiv genomics preprints (MVP EWAS; rare CNV) and an odour-cueing-during-sleep preprint. Each is unreviewed, and none changes a page claim.

Not done. No landmark note: nothing this sweep found changed practice. No new patient-organisation material. combatstress.org.uk returned 403 again, and canada.ca failed at connection, so audit follow-up #4 remains open with no evidence that either resource changed. APA 2025, Phoenix Australia, RANZCP and WHO registry entries were not re-fetched (audit follow-up #5 still open).

Error made and corrected in-session. A scripted edit to guidelines.md replaced the remainder of a line, deleting one sentence (the pediatric-drug-evidence sentence citing PMID 32757557). I restored it verbatim from the published copy in public/docs/ and then diffed every edited page against its published copy, sentence by sentence. No other original sentence was lost.

Pages changed (all → status: draft, last-curated: 2026-10-09): pharmacotherapy, mdma-and-psychedelic-assisted-therapy, clinical-trials-landscape, early-intervention-and-prevention, children-and-adolescents, comorbidity, dropout-and-nonresponse, comparative-psychotherapy-evidence. guidelines.md was already draft. Also updated: BIBLIOGRAPHY (32 records; 417 total), STATISTICS (8 rows, 2 caveats), REGISTRY, OPEN-QUESTIONS (OQ-1/4/5/6/16/17 updated, D21 added), INDEX. New file: literature/sweeps/2026-10-09.json.

For the auditor (a different engine)

Re-fetch the 32 added PMIDs and 7 added NCTs. Check the Bertolini/Astill Wright framing, and promote guidelines.md if items 4–5 hold. Read the Green 2026 and Fares-Otero 2026 included-study tables, if obtainable, to see whether either pooled MP4-site data.

For the next sweep

  1. NCT03539614. Still the top item for OQ-4.
  2. NCT04560660 journal publication: does it report an analysis the registry omits?
  3. NCT06853912 (psilocybin vs placebo, primary completion due November 2026). It could be the first randomized psilocybin PTSD readout.
  4. Cochrane CD002795. Establish what the 2026 version changed if any route to its full text opens. Watch for the child-PTSD Cochrane review (protocol PMID 40326577) to publish.
  5. Whether the pooled MDMA effect survives exclusion of MP4-site data (OQ-5).
  6. Carry-overs: audit follow-ups #4 and #5. Try WHO ICTRP by another route.

2026-10-16 — Literature sweep (Codex)

Scope and dates. Read CONVENTIONS.md, CLAUDE.md, SOURCES.md, the full PTSD log/index and the previous sweep's follow-ups. Although a sweep already ran on 2026-10-09, searched the requested 2026-09-02 through 2026-10-16 publication-date window, then deduplicated against that sweep and the bibliography. A supplementary Entrez-date search catches newly indexed papers. Publication-date matching can capture final issue dates after an earlier online publication; the two July-online/October-issue additions are labelled accordingly. Only conditions/ptsd/ was changed. No publishing or git commands were run.

Searches and sources actually queried. Exact strings, PubMed translations, returned identifiers, source access results and per-trial checks are in literature/sweeps/2026-10-16.json (the canonical manifest location; no new directory was invented).

Source What was actually done Boundary
PubMed E-utilities 21 topic searches plus a separate windowed Cochrane search for each topic; broad PDAT and EDAT searches; historical Cochrane check (45 main searches); 5 targeted all-date follow-ups 1,064 unique journal records fetched in main retrieval; 1,109 with targeted follow-ups. These are retrieval counts, not full-text review counts. Broad post-traumatic terms return incidental orthopedic/TBI records, excluded in triage.
Major topics Diagnosis, CPTSD, epidemiology/risk, neurobiology/biomarkers, PE, CPT, EMDR, comparative psychotherapy/delivery, dropout, medication/neuromodulation, sleep/nightmares, MDMA/psychedelics/ketamine, prevention, military/veterans, children, comorbidity, moral injury, guidelines, trials, patient experience and safety Query terms and translations retained verbatim.
Cochrane Database of Systematic Reviews, through PubMed Separate check per topic in the publication window; broad all-date search returned 82 records; pediatric review follow-up also run No in-window CDSR record returned. This does not establish that no future update exists. Cochrane Library/CENTRAL was not searched (HTTP 403 access boundary in SOURCES.md).
Europe PMC REST Same 21 topics with FIRST_PDATE range; additional identifier lookup and full-text endpoints 522 unique records: 377 MED, 55 PMC and 90 PPR. Some PMC records duplicate PubMed entries. No Europe-PMC-only record survived triage; no DOI-only journal citation was added. Nine additional PMID identifiers were separately verified through E-utilities (including eight book chapters). MED identifier lookups did not find the retained papers, while PMC full-text XML for two of them was accessible; those observations are recorded separately.
Crossref Resolved DOI metadata and updated-by for every added paper, alongside PubMed publication types and CommentsCorrections All five additions clear on both checks. One 429 was retried successfully before retention. No personal email or mailto was sent.
ClinicalTrials.gov v2 Individually retrieved all 22 NCT records cited in PTSD Markdown, including those added on 2026-10-09 No tracked status or results-posting change identified relative to the last sweep. Last-update, completion, enrollment and results dates retained per record.
ISRCTN Successful XML API queries for psilocybin/PTSD, psilocybin/post-traumatic, ketamine/PTSD, MDMA/PTSD, and condition-specific PTSD (82 records) The initial /api/query route returned 404; /api/query/format/default worked. Psilocybin searches returned healthy-volunteer/depression/other-condition records, no PTSD-directed trial. Text matches are not assumed to be PTSD efficacy trials.
WHO ICTRP The literal broad posttraumatic stress disorder query returned an HTML results page reporting 20 trials; 10 displayed rows read Partial access only. Drug-specific and alternate-term requests returned HTTP 403. No drug-specific or global registry absence is inferred. CTIS/ChiCTR/CTRI were not separately searched.
Guideline bodies ISTSS, AWMF, VA/DoD, NICE, Phoenix Australia, RANZCP, WHO; APA official search result and attempted direct page APA direct retrieval blocked; search-result verification of its 2025 listing is not full guideline re-verification. NICE and VA/DoD direct HTTP requests succeeded despite earlier/web-reader access failures.
Statistics/burden VA epidemiology portal, PTSD Repository/data-release metadata; September MAP ALLIANCE economic briefing traced from PTSD UK to the original PDF No new national registry release verified in the requested window. Economic figures are source-specific observational estimates, not national PTSD prevalence or proven intervention savings.
Public/patient organizations PTSD UK, Blue Knot, Combat Stress and Canada's public PTSD portal; selected public campaign and resource pages Combat Stress/Canada retrieval succeeded, closing the earlier access follow-up. Public organization communications only; no private patient identities or individual histories retained.
Sources not searched CENTRAL; SciELO/LILACS (HTTP 403); subscription Embase/Scopus/Web of Science; Unpaywall Regional transportability claims remain bounded by the SciELO/LILACS gap. Unpaywall skipped because LIFEBANK_CONTACT_EMAIL was unset.

Triage and findings retained. Five papers added, raising the bibliography to 422 distinct PMIDs. Three supplied small, source-verified synthesis edits; two are bibliography-only. No landmark note was justified.

  1. The MP4 sub-question is partly answered. The 11 October living MDMA synthesis includes six primary RCTs and explicitly excludes pooled MP4-containing secondary reports in supplementary Table 10. Its primary-endpoint symptom effect remains favourable, but overall certainty is low and all trials use the MAPS model (Sevchik 2026, PMID 42860436). Read the full article, Table 1, Figure 1 and supplement; visually checked the PDF figure/exclusion table. Kept the 242-person analysis denominator distinct from the 286 randomized participants reported for selected arms. This does not establish independent trial replication or resolve all earlier reviews' inclusion choices. The supplement also has apparent MP-1/MP-2 registry-crosswalk errors; none was imported. Updated the MDMA page, statistics and OQ-5.
  2. Completion definitions complicate the pacing question. Read the full repository-based CPT/PE/EMDR meta-regression, its tables and limitations (Horton 2026, PMID 42504047). Retained the exploratory nature of the pacing association and heterogeneous definitions, without turning a study-level association into a causal delivery recommendation. Updated dropout and OQ-1. First online July; October issue.
  3. Same-sample diagnostic measurement comparison. Read the full PCL-5/ITQ comparison in Syrian refugees and Table 1 (Alpay 2026, PMID 42438360). Retained distinct self-report classification estimates, with no claim that either nosology is more accurate or predicts treatment response. Updated diagnosis, statistics and OQ-2. First online July; October issue. SciELO/LILACS regional-coverage limitation remains explicit.
  4. Bibliography only: the new PE meta-analysis (Zhao 2026, PMID 42854790) and youth complex-trauma component network meta-analysis (Li 2026, PMID 42858309). PubMed metadata/abstracts and Crossref verified; full texts unavailable (Karger returned 403). No effect size or new treatment-gap claim imported from their abstracts. Youth complex trauma is not assumed equivalent to ITQ-defined CPTSD.
  5. Guideline registry: added the previously uncatalogued German S3 DeGPT/AWMF version 7.0 (February/May 2026, outside the requested window); recorded the ISTSS forthcoming-update announcement without treating it as released recommendations. Phoenix/RANZCP, VA/DoD and WHO landing pages were re-fetched. Detailed German recommendation synthesis remains pending.
  6. Burden and public material: read the September MAP ALLIANCE report and visually checked its cost figure. Retained mother-and-baby NHS service-use costs with the analytic groups, symptom-based classification and observational limits; omitted the national savings projection. Added PTSD UK's advertised October documentary discussion, Blue Knot's 29 October awareness campaign and accessible Combat Stress resources to the patient-source layer, without efficacy claims or individual patient narratives.

Follow-ups checked without a new result. Exact PubMed identifier searches for the prazosin biomarker trial and ketamine-plus-PE trial returned zero records (NCT03539614; NCT04560660). Their registry states/results remain as previously recorded. A wider ketamine/PE search still identified a protocol, reviews and adjacent studies rather than the tracked trial's results publication. The PubMed psilocybin randomized-design search returned 37 records, screened as reviews/protocols or other drug/population studies rather than a PTSD randomized efficacy readout. The four tracked randomized psilocybin records still lack posted results (NCT07570654, NCT06853912, NCT06885996, NCT06407635). These are source-bounded observations, not worldwide absences.

Triaged out. Most broad retrievals were incidental physical trauma/TBI, cross-sectional associations, duplicate records, uncontrolled/case material or preliminary/preprint findings. The newly read active-duty moral-injury synthesis was not imported: its full-text study table includes mixed veteran populations and a longitudinal study, requiring more extraction than its abstract's active-duty/cross-sectional framing supports. Existing bibliography records were not re-added. The 2026 Cochrane pharmacotherapy version and pediatric protocol remain follow-ups from the prior sweep; this session did not obtain a new full-text version-difference analysis or a completed pediatric CDSR review.

Files and checks. Edited five wiki pages (diagnosis, dropout, MDMA, guidelines, trials), BIBLIOGRAPHY, REGISTRY, STATISTICS, OPEN-QUESTIONS, INDEX and two patient-voice files. Changed pages carry last-curated: 2026-10-16 and status: draft; diagnosis is newly demoted, leaving 12 curated + 10 draft wiki pages. Added only the canonical dated JSON manifest and this single log entry. Mechanical validation verified every newly written inline PMID/NCT against live session retrieval, both retraction checks for all five additions, all condition-relative Markdown links (zero broken), bibliography count and page statuses. This is not an independent audit; no page was promoted. The downstream auditor should be a different engine. Site generation/publication was left to the publishing workflow as instructed.

Next sweep.

  1. Prazosin biomarker results and ketamine-plus-PE publication remain top registry/publication follow-ups.
  2. Watch the PTSD-plus-AUD psilocybin trial's November completion and all controlled psilocybin results; use PubMed, ClinicalTrials.gov and non-US registries with their source limits retained.
  3. Retrieve the PE and pediatric component-review full texts before adding numerical synthesis or revising OQ-7/OQ-9; distinguish complex trauma exposure from ICD-11 CPTSD.
  4. Compare the Green and Fares-Otero review-specific included-study tables with the new living review. Its MP4 exclusion partly closes the contamination sub-question, while independent replication and safety/expectancy remain open.
  5. Watch the actual ISTSS guideline release; review the German S3 recommendations before adding a cross-guideline comparison. Revisit APA direct access, Phoenix living updates and WHO mhGAP separately from the 2013 document.
  6. Revisit the Cochrane pharmacotherapy version change and pediatric review completion. Retry drug-specific WHO ICTRP access; broad-page success does not establish complete coverage.

2026-10-23 — Literature sweep (Grok)

Scope and dates. Read CONVENTIONS.md, CLAUDE.md, SOURCES.md, LOG.md and INDEX.md. Searched the requested publication window 2026-09-02 through 2026-10-23, then removed records already in the 2026-10-16 manifest. A paired Entrez-date search covered 2026-10-17 through 2026-10-23. Only conditions/ptsd/ was changed. No git commands were run and nothing was published. An independent audit is pending. No page was promoted to curated.

Searches and sources actually queried. Queries, translations, the 110 new PMIDs, trial checks and source HTTP codes are in literature/sweeps/2026-10-23.json.

Source What was actually done Boundary
PubMed E-utilities 21 topic searches, each with a paired "Cochrane Database Syst Rev"[jour] search; broad PDAT and EDAT searches; all-dates Cochrane; retraction publication types; exact-ID searches for NCT03539614 and NCT04560660; psilocybin randomized-design search; child Cochrane title search; 2026 practice-guideline publication type 110 PMIDs were new against the 2026-10-16 id list. These are retrieval counts, not full-text review counts. No API key was set.
Cochrane, through PubMed Every topic window returned 0. The all-dates search returned 82, the same 82 as on 2026-10-16, and none of those 82 were new. The child-title search returned 17, and none were new No new CDSR record in PubMed in this window. That is a PubMed finding. Cochrane Library and CENTRAL were not searched. cochranelibrary.com returned HTTP 403.
Europe PMC REST The same topics for 2026-10-17 to 2026-10-23, plus a non-MEDLINE window (195 hits), a preprint slice (6) and a broad delta (43) No Europe-PMC-only record was cited. No DOI-only journal citation was added. Europe PMC full-text XML returned HTTP 500 for two PMCs; NCBI efetch db=pmc then retrieved those two.
Crossref DOI metadata and updated-by for all 12 retained records. No mailto All 12 returned HTTP 200 with an empty updated-by. PubMed publication types on the same 12 carried no retraction or expression-of-concern flag.
ClinicalTrials.gov v2 All 22 cited NCT records, plus update, results, first-posted and psilocybin condition queries One tracked status change: NCT05554094 is now completed, actual enrollment 12, last update 2026-10-16, no results posted.
ISRCTN /api/query/format/default for psilocybin, ketamine, MDMA, methylone, prazosin, and a broad PTSD query HTTP 200. Psilocybin hits were not PTSD efficacy trials. MDMA, methylone and prazosin returned 0. The broad query stopped at 200, so it is incomplete.
WHO ICTRP Broad, hyphenated, psilocybin, prazosin, ketamine and MDMA queries HTTP 502 on every query. Not searched. No drug-specific or global absence is claimed.
EU CTIS Public API and the HTML search page API HTTP 403. The HTML page returned HTTP 200 and is a JavaScript shell, so it was not a completed trial search. ChiCTR and CTRI were not searched.
DOAJ and OpenAlex DOAJ 2026 title queries. OpenAlex 2026-10-17 to 2026-10-23 DOAJ first pages did not yield an in-window record absent from PubMed. OpenAlex post-traumatic stress returned 94, of which 38 of the 50 records read were Zenodo deposits, including formulaic district-hospital titles. is_retracted was false. None was cited.
Guideline and organisation pages NICE, ISTSS, AWMF, Phoenix, RANZCP, WHO, APA, VA/DoD, PTSD UK, Blue Knot, Combat Stress, Canada, VA epidemiology HTTP codes are in the manifest. No new recommendation text was synthesised.
Not searched CENTRAL; SciELO (HTTP 403) and LILACS; Embase, Scopus and Web of Science; Unpaywall Unpaywall was skipped because LIFEBANK_CONTACT_EMAIL was unset. SciELO and LILACS could not be searched, so no claim about regional literature is made from their absence.

Triage. Most of the 110 new records were physical-trauma false positives, cross-sectional associations, commentaries, pilots, or screens used as if they were diagnoses. Twelve records were added. The bibliography now holds 434 unique PMIDs. Seven are cited on a wiki page, one is cited only from the open questions, and four are catalogue-only. No landmark note was warranted.

  1. Displaced-population CPTSD prevalence is a descriptive summary, not a new global rate. Full text of Melkam 2026 (PMID 42900526): 17 samples, n = 12,504, pooled 20.9% (95% CI 12.6–32.6%), prediction interval 1.7–80.3%, I² = 98.3%, community 10.6%, treatment-seeking 55.2%. Placed beside the Maercker 1–8% row on the complex-PTSD page. That page was demoted to draft.
  2. ITQ clinical checks halved a quota-sample rate. Full text of Hyland 2026 (PMID 42905693): of all 5,070 participants, 19.2% met ICD-11 PTSD or CPTSD requirements on the standard ITQ and 9.8% did so with clinical checks. This is not a national prevalence and not a treatment-response finding. Diagnosis page, statistics and OQ-2 updated. SciELO and LILACS remained blocked.
  3. Depression outcomes of PTSD psychotherapy, abstract only. Hoppen 2026 (PMID 40830864) reports g = 0.97 versus passive controls and g = 0.50 versus active controls. Full text was not retrieved, and the wiki sentence says so. First online 20 August 2025; October 2026 issue.
  4. Military Health System dose, abstract only. McLean 2026 (PMID 42906525): of 3,459 patients, 51.3% initiated PE, CPT or EMDR; 25.7% received three sessions in 90 days; 7.5% received eight sessions in 14 weeks. Both thresholds are the paper's "minimally adequate dosage". Military page demoted to draft. OQ-1 notes that loss continues after initiation.
  5. Psilocybin media review does not erase the 2026 uncontrolled trials. Full text Table 3 of Madden 2026 (PMID 42900476): no PTSD trial in a search that ended 10 October 2024, while 74/172 media articles named PTSD. The randomized-publication gap is unchanged. NCT05554094 is now completed in the registry at actual n = 12, with no results posted, which agrees with the published open-label pilot.
  6. Benzodiazepine prescribing in Canadian OSI clinics. Full text of Collins 2026 (PMID 42898444): 22% of 438 patients, OR 1.12 per year of PTSD, monotherapy under 1%. Safety page demoted to draft. This is prescribing prevalence in a referral-enriched setting.
  7. VA pain Delphi, abstract only. Zaccari 2026 (PMID 41851426) reached consensus on 48 of 71 items. Expert consensus, not an outcome trial. Comorbidity and OQ-15.
  8. Catalogue only, with the limit written on the line. Exercise network meta-analysis (Eun 2026, PMID 42881604): g = −0.49, prediction interval crosses the null, CINeMA very low, so no modality ranking. Written-exposure plus tDCS pilot (Straud 2026, PMID 42893417): n = 25, primary between-group null. War-adapted brief exposure (Nacasch 2026, PMID 42885536): probable PTSD rates did not differ. Graduated-exposure distress paper (Buccellato 2026, PMID 42177712): peak SUDS from the results section, not the abstract's t(183) = 466 typo; not an efficacy result. Gene-expression paper (Xu 2026, PMID 42897160): 6 versus 11 complete profiles, and a trajectory class of 8 versus 11; cited only on OQ-12 so the title's "predict" is not taken as solved.

Registry. NCT03539614 remains active, not recruiting, last update 2026-08-14, no results; PubMed exact-ID search returned 0. NCT04560660 remains completed, results posted 2026-07-15, and the exact-ID PubMed search returned 0. NCT07570654 remains recruiting, estimated n = 300, last update 2026-10-21, primary completion estimated November 2028, no results; the field that changed on 21 October was not identified. ISRCTN found no PTSD-directed psilocybin efficacy trial. WHO ICTRP was not searched (HTTP 502).

Watched and not added. Results posted for NCT04515784 are single-arm and were not imported as efficacy. NCT03196999 results, already judged on 2026-10-09, still show no arm separation. Newly posted registrations NCT07880340 (deep TMS) and NCT07886840 (salience-network rTMS) are not yet recruiting and were not added to the 22 cited records. A Gaza IES-R convenience sample and a five-per-arm complex-psychotrauma pilot were not added. Screening scores were not entered as diagnoses.

Guidelines, statistics, organisations. NICE evidence index (HTTP 200) still lists the July 2026 exceptional surveillance as the latest entry; the decision document was not re-opened. VA/DoD page title is still the 2023 guideline (HTTP 200). AWMF notice still states version 7.0, register 155-001, valid until 26 February 2031; recommendation text was not reviewed. A 22 October 2026 AWMF statement on that page is about a different quality-criteria draft. ISTSS guideline URL returned HTTP 403. Phoenix returned HTTP 403. APA returned HTTP 200 with an empty body. PTSD UK and Blue Knot returned HTTP 403. Combat Stress returned HTTP 200 and the excerpt showed no new campaign. The Canada page did not connect. The VA epidemiology page returned HTTP 200 as navigation, and no new national figure was extracted.

Not done, and not a negative finding. Full texts of Zhao 2026 (PMID 42854790) and Li 2026 (PMID 42858309) were not retrieved. The Cochrane pharmacotherapy version (CD002795) was not compared in full text, and the pediatric Cochrane review has not completed. Green (PMID 42708350) and Fares-Otero (PMID 41825162) inclusion tables were not compared with Sevchik 2026 (PMID 42860436). The German S3 recommendations were not synthesised. APA and Phoenix were not re-read in full. Hoppen and McLean full texts were not retrieved.

Files. Edited diagnosis, complex PTSD, comorbidity, military, MDMA, trials landscape, safety, BIBLIOGRAPHY, REGISTRY, STATISTICS, OPEN-QUESTIONS and INDEX. Complex PTSD, military and safety moved from curated to draft. Wiki frontmatter is now 9 curated and 13 draft. Added this log entry and the manifest at literature/sweeps/2026-10-23.json. WHATS-NEW.md was not edited. This session did not audit its own writing.

Next sweep.

  1. Prazosin biomarker results (NCT03539614) and a journal paper for ketamine-plus-PE (NCT04560660) remain unpublished in PubMed.
  2. Controlled psilocybin readouts, especially NCT06853912 (estimated primary completion November 2026) and NCT07570654 (estimated November 2028). NCT05554094 is completed in the registry without a posted results section; the open-label paper is already cited.
  3. Retrieve full texts before any numerical upgrade: Zhao PMID 42854790, Li PMID 42858309, Hoppen PMID 40830864, McLean PMID 42906525, and Cochrane CD002795.
  4. Compare Green and Fares-Otero inclusion tables with Sevchik PMID 42860436.
  5. Watch the ISTSS release. Review German S3 recommendations before a cross-guideline comparison. Revisit APA, Phoenix and WHO mhGAP. The 22 October 2026 AWMF statement is not a PTSD guideline update.
  6. Retry WHO ICTRP. This session was HTTP 502 on every query. SciELO, LILACS and CENTRAL remain blocked. Do not upgrade the single-arm START-PTSD registry results (NCT04515784) without a publication. The new rTMS registrations are NCT07880340 and NCT07886840.