PDF(Pubmed)
Abstract：
Several phase II studies have demonstrated that psilocybin-assisted therapy shows therapeutic potential across a spectrum of neuropsychiatric conditions, including major depressive disorder (MDD). However, the mechanisms underlying its often persisting beneficial effects remain unclear. Observational research suggests that improvements in psychological flexibility may mediate therapeutic effects. However, no psychedelic trials to date have substantiated this finding in a clinical sample. In an exploratory placebo-controlled, within-subject, fixed-order study, individuals with moderate to severe MDD were administered placebo (n = 19) followed by psilocybin (0.3 mg/kg) (n = 15) 4 weeks later. Dosing sessions were embedded within a manualized psychotherapy that incorporated principles of Acceptance and Commitment Therapy. Depression severity, psychological flexibility, mindfulness, and values-congruent living were measured over a 16-weeks study period. Psychological flexibility, several facets of mindfulness, and values-congruent living significantly improved following psilocybin and were maintained through week 16. Additionally, improvements in psychological flexibility and experiential acceptance were strongly associated with reductions in depression severity following psilocybin. These findings support the theoretical premise of integrating psilocybin treatment with psychotherapeutic platforms that target psychological flexibility and add to emerging evidence that increasing psychological flexibility may be an important putative mechanism of change in psilocybin-assisted therapy for MDD and potentially, other mental health conditions.
摘要：
几项II期研究表明，psilocybin辅助治疗在一系列神经精神疾病中显示出治疗潜力，包括抑郁症（MDD）。然而,其通常持续存在的有益作用的潜在机制仍不清楚.观察性研究表明，心理灵活性的改善可能介导治疗效果。然而,迄今为止,尚无迷幻试验在临床样本中证实这一发现.在探索性安慰剂对照中，在主题内，定序研究，对中度至重度MDD患者给予安慰剂(n=19),4周后给予psilocybin(0.3mg/kg)(n=15).剂量会议被嵌入在一个手册化的心理治疗中，该治疗结合了接受和承诺治疗的原则。抑郁严重程度,心理灵活性，正念,在16周的研究期内测量了价值-一致的生活。心理灵活性,正念的几个方面，和价值观一致的生活在psilocybin之后显着改善，并保持到16周。此外,心理灵活性和经验接受度的改善与psilocybin治疗后抑郁严重程度的降低密切相关.这些发现支持了将psilocybin治疗与针对心理灵活性的心理治疗平台整合的理论前提，并增加了新的证据，即增加心理灵活性可能是psilocybin辅助治疗MDD改变的重要推定机制，其他心理健康状况。
