Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer
Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer
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DOI：
10.1177/0269881119897615
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发表时间：
2020-01-09
影响因子：
4.1
通讯作者：
Ross, Stephen
中科院分区：
文献类型：
--
作者：
Agin-Liebes, Gabrielle, I;Malone, Tara;Ross, Stephen
背景：最近发表的一项随机对照试验比较了单剂量裸盖菇素与单剂量烟酸联合心理治疗对癌症相关精神困扰患者的影响。结果表明，裸盖菇碱辅助心理治疗有助于改善精神和存在的痛苦，生活质量和精神健康，直到七周前的交叉。在6.5个月的随访中，在交叉后，60-80%的参与者继续满足临床显著抗抑郁或抗焦虑反应的标准。方法：目前的研究是一项长期的受试者随访分析，包括一组完成父母试验的参与者的自我报告的症状。研究人员联系了所有仍然活着的16名参与者，其中15名参与者同意在服用裸盖菇素后的平均3.2年和4.5年参加研究。结果：在第一次和第二次随访中，焦虑、抑郁、绝望、士气低落和死亡焦虑持续减少。组内效应量很大。在第二次（4.5年）随访中，大约60-80%的参与者符合临床显著抗抑郁或抗焦虑反应的标准。绝大多数参与者（71% -100%）将积极的生活变化归因于裸盖菇素辅助治疗经历，并将其评为他们生活中最有个人意义和精神意义的经历之一。结论：这些发现表明，裸盖菇素辅助心理治疗有望促进癌症相关精神困扰的长期缓解。然而，由于父母研究的交叉设计，关于这种治疗的疗效可以得出有限的结论。尽管如此，目前的研究增加了新兴的文献基础，表明裸盖菇素促进的治疗可能会增强危及生命的癌症患者的心理、情感和精神健康。
Background: A recently published randomized controlled trial compared single-dose psilocybin with single-dose niacin in conjunction with psychotherapy in participants with cancer-related psychiatric distress. Results suggested that psilocybin-assisted psychotherapy facilitated improvements in psychiatric and existential distress, quality of life, and spiritual well-being up to seven weeks prior to the crossover. At the 6.5-month follow-up, after the crossover, 60-80% of participants continued to meet criteria for clinically significant antidepressant or anxiolytic responses.Methods: The present study is a long-term within-subjects follow-up analysis of self-reported symptomatology involving a subset of participants that completed the parent trial. All 16 participants who were still alive were contacted, and 15 participants agreed to participate at an average of 3.2 and 4.5 years following psilocybin administration.Results: Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at the first and second follow-ups. Within-group effect sizes were large. At the second (4.5 year) follow-up approximately 60-80% of participants met criteria for clinically significant antidepressant or anxiolytic responses. Participants overwhelmingly (71-100%) attributed positive life changes to the psilocybin-assisted therapy experience and rated it among the most personally meaningful and spiritually significant experiences of their lives.Conclusion: These findings suggest that psilocybin-assisted psychotherapy holds promise in promoting long-term relief from cancer-related psychiatric distress. Limited conclusions, however, can be drawn regarding the efficacy of this therapy due to the crossover design of the parent study. Nonetheless, the present study adds to the emerging literature base suggesting that psilocybin-facilitated therapy may enhance the psychological, emotional, and spiritual well-being of patients with life-threatening cancer.