The association between diverse psychological protocols and the efficacy of psilocybin-assisted therapy for clinical depressive symptoms: a Bayesian meta-analysis
Frontiers in Psychiatry – August 13, 2024
Source: OpenAlex
Summary
Surprisingly, the type of psychological support offered alongside psilocybin treatment doesn't significantly alter its effectiveness for clinical depression. A meta-analysis of 10 studies, involving 515 adult patients, explored how different psychotherapist approaches, from manualized directive to non-manualized supportive, impacted outcomes. Psilocybin, a psychedelic alkaloid, showed a strong standardized mean difference of 10.08 in reducing depressive symptoms. This suggests that while psilocybin-assisted therapy holds promise in psychiatry and clinical psychology, the specific psychological protocol may be less critical than previously thought in these Complementary and Alternative Medicine Studies.
Abstract
Objective Psilocybin-assisted therapy has shown promising efficacy on clinical depressive symptoms. However, diverse psychological support or psychotherapy was performed with psilocybin treatment. This study aimed to explore the association of psychological protocols with the efficacy of psilocybin-assisted therapy for depressive symptoms. Method Five major databases were systemic searched for clinical trials addressing psilocybin-assisted therapy for patients with clinical depressive symptoms. A Bayesian random-effects meta-analysis and meta-regression were performed. The effect size was mean difference (with 95% credible interval) measured by 17-Item Hamilton Depression Rating Scale. Results There were 10 eligible studies including 515 adult patients with clinically diagnosed depression. The psychological protocols could be categorized into four types: (i) manualized directive psychotherapy(k=1); (ii) manualized nondirective psychological support(k=3), (iii) non-manualized nondirective psychological support(k=5); and (iv) non-manualized supportive psychotherapy(k=1). The pooled standard mean difference of psilocybin-assisted therapy was 10.08 (5.03-14.70). Conclusion Compared with manualized nondirective psychological support, the other three psychological approaches did not differ significantly. The improvement of depressive symptoms was not associated with the psychological protocols in adult patients receiving psilocybin-assisted therapy. Systemic review registration Open Science Framework: identifier (osf.io/3YUDV).