Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression.
Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression.
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急性迷幻经验的质量可以预测psilocybin对治疗抑郁症的治疗功效。
DOI：
10.3389/fphar.2017.00974
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发表时间：
2017
影响因子：
5.6
通讯作者：
Carhart-Harris RL
中科院分区：
文献类型：
--
作者：
Roseman L;Nutt DJ;Carhart-Harris RL
简介：“迷幻”治疗模式的一个基本原则是，急性体验的质量可以介导心理健康的长期改善。在本文中，我们试图测试这一点，从临床试验评估裸盖菇素治疗难治性抑郁症（TRD）的数据。与以前的报告一致，我们假设海洋无边（OBN）（与神秘型体验共享特征）和自我溶解恐惧（DED）（类似于焦虑）的发生和程度将预测长期的积极结果，而感官知觉效应的预测价值可以忽略不计。材料与方法：20例难治性抑郁症患者接受了裸盖菇素治疗（两个单独的疗程：10和25 mg裸盖菇素）。使用意识状态改变（ASC）问卷评估25 mg裸盖菇素治疗期间的体验质量。从ASC中，OBN和DED维度分别用于测量神秘型和挑战性体验。第5周的抑郁症状自评快速量表（QIDS-SR）作为终点临床结局指标，因为在随后的时间点，一些受试者继续接受新的治疗，因此混淆了推论。在重复测量ANOVA中，时间是受试者内因素（自变量），QIDS-SR是基线、1天、1周、5周的受试者内因变量。OBN和DED是自变量。OBN与时间和DED与时间的相互作用是主要关注的结局。结果如下：对于OBN和DED与时间的相互作用（QIDS-SR作为因变量），与基线相比，主效应和每个时间点的效应均具有显著性（主效应分别为p = 0.002和p = 0.003），证实了我们的主要假设。此外，与ASC的感知维度相比，OBN与QIDS-SR（5周）的Pearson相关性是特异性的（p < 0.05）。讨论内容：这份报告进一步支持了这样一种观点，即急性迷幻体验的质量是心理健康长期变化的关键因素。未来的致幻剂治疗工作应该认识到经验质量在确定治疗效果方面的重要性，并考虑如何增强神秘型经验和减少焦虑。试验注册：ISRCTN，编号ISRCTN 14426797，http://www.isrctn.com/ISRCTN14426797
Introduction: It is a basic principle of the “psychedelic” treatment model that the quality of the acute experience mediates long-term improvements in mental health. In the present paper we sought to test this using data from a clinical trial assessing psilocybin for treatment-resistant depression (TRD). In line with previous reports, we hypothesized that the occurrence and magnitude of Oceanic Boundlessness (OBN) (sharing features with mystical-type experience) and Dread of Ego Dissolution (DED) (similar to anxiety) would predict long-term positive outcomes, whereas sensory perceptual effects would have negligible predictive value. Materials and Methods: Twenty patients with treatment resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin). The Altered States of Consciousness (ASC) questionnaire was used to assess the quality of experiences in the 25 mg psilocybin session. From the ASC, the dimensions OBN and DED were used to measure the mystical-type and challenging experiences, respectively. The Self-Reported Quick Inventory of Depressive Symptoms (QIDS-SR) at 5 weeks served as the endpoint clinical outcome measure, as in later time points some of the subjects had gone on to receive new treatments, thus confounding inferences. In a repeated measure ANOVA, Time was the within-subject factor (independent variable), with QIDS-SR as the within-subject dependent variable in baseline, 1-day, 1-week, 5-weeks. OBN and DED were independent variables. OBN-by-Time and DED-by-Time interactions were the primary outcomes of interest. Results: For the interaction of OBN and DED with Time (QIDS-SR as dependent variable), the main effect and the effects at each time point compared to baseline were all significant (p = 0.002 and p = 0.003, respectively, for main effects), confirming our main hypothesis. Furthermore, Pearson's correlation of OBN with QIDS-SR (5 weeks) was specific compared to perceptual dimensions of the ASC (p < 0.05). Discussion: This report further bolsters the view that the quality of the acute psychedelic experience is a key mediator of long-term changes in mental health. Future therapeutic work with psychedelics should recognize the essential importance of quality of experience in determining treatment efficacy and consider ways of enhancing mystical-type experiences and reducing anxiety. Trial Registration: ISRCTN, number ISRCTN14426797, http://www.isrctn.com/ISRCTN14426797
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DOI：
10.1177/0269881117725915
发表时间：
2017-09
期刊：
Journal of psychopharmacology (Oxford, England)
影响因子：
--
作者：
Carhart-Harris RL;Nutt DJ
通讯作者：
Nutt DJ
影响因子：
3.7
作者：
Branchi, Igor
通讯作者：
Branchi, Igor
影响因子：
4.6
作者：
Atasoy S;Roseman L;Kaelen M;Kringelbach ML;Deco G;Carhart-Harris RL
通讯作者：
Carhart-Harris RL
影响因子：
3.4
作者：
Carhart-Harris RL;Bolstridge M;Day CMJ;Rucker J;Watts R;Erritzoe DE;Kaelen M;Giribaldi B;Bloomfield M;Pilling S;Rickard JA;Forbes B;Feilding A;Taylor D;Curran HV;Nutt DJ
通讯作者：
Nutt DJ
DOI：
10.1073/pnas.1518377113
发表时间：
2016-04-26
影响因子：
11.1
作者：
Carhart-Harris, Robin L.;Muthukumaraswamy, Suresh;Nutt, David J.
通讯作者：
Nutt, David J.