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The association between diverse psychological protocols and the efficacy of psilocybin-assisted therapy for clinical depressive symptoms: a Bayesian meta-analysis

Summary

This research examined how different types of psychological support during psilocybin treatment affect depression outcomes. Researchers analyzed 10 clinical trials involving 515 patients with depression. They found that whether therapists used structured manuals or flexible approaches, or whether therapy was directive or non-directive, the depression improvement from psilocybin treatment was similar across all approaches.

Background

Major Depressive Disorder (MDD) is a significant global health burden with inadequate treatment response in one-third to one-half of patients using antidepressants. Psilocybin-assisted therapy has shown promising rapid and sustained antidepressant effects in clinical trials. However, diverse psychological support and psychotherapy approaches are used alongside psilocybin administration, creating variability in treatment protocols.

Objective

To explore the association between different psychological protocols and the efficacy of psilocybin-assisted therapy for depressive symptoms using a Bayesian meta-analysis approach. The study aimed to determine whether specific psychological support or psychotherapy types influence treatment outcomes.

Results

Ten eligible studies included 515 adult patients. Psychological protocols were categorized into: manualized directive psychotherapy (k=1), manualized nondirective psychological support (k=3), non-manualized nondirective psychological support (k=5), and non-manualized supportive psychotherapy (k=1). The pooled standard mean difference was 10.08 (5.03-14.70). Compared with manualized nondirective psychological support, no significant differences were found between other psychological approaches.

Conclusion

Improvement in depressive symptoms with psilocybin-assisted therapy was not significantly associated with the type of psychological protocol used. However, standardized psychological protocols and therapist training programs should be established for consistency and quality. Future factorial design RCTs are recommended to distinguish individual contributions of drug and psychotherapy.
  • Published in:Frontiers in Psychiatry,
  • Study Type:Bayesian Meta-analysis,
  • Source: PMID: 39193583, DOI: 10.3389/fpsyt.2024.1439347
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