Zeifman Richard J, Palhano-Fontes Fernanda, Hallak Jaime, Arcoverde Emerson, Maia-Oliveira João Paulo, Araujo Draulio B
Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
Front Pharmacol. 2019 Nov 19;10:1325. doi: 10.3389/fphar.2019.01325. eCollection 2019.
Suicide is a major public health problem. Given increasing suicide rates and limitations surrounding current interventions, there is an urgent need for innovative interventions for suicidality. Although ayahuasca has been shown to target mental health concerns associated with suicidality (i.e., depression and hopelessness), research has not yet explored the impact of ayahuasca on suicidality. Therefore, we conducted secondary analyses of a randomized placebo-controlled trial in which individuals with treatment-resistant depression were administered one dose of ayahuasca ( = 14) or placebo ( = 15). Suicidality was assessed by a trained psychiatrist at baseline, as well as 1 day, 2 days, and 7 days after the intervention. A fixed-effects linear mixed model, as well as between and within-groups Cohen's effect sizes were used to examine changes in suicidality. Controlling for baseline suicidality, we found a significant effect for time ( < .05). The effect of the intervention (i.e., ayahuasca vs. placebo) trended toward significance ( = .088). At all time points, we found medium between-group effect sizes (i.e., ayahuasca vs. placebo; day 1 Cohen's = 0.58; day 2 d = 0.56; day 7 d = 0.67), as well as large within-group (ayahuasca; day 1 Cohen's = 1.33; day 2 d = 1.42; day 7 d = 1.19) effect sizes, for decreases in suicidality. Conclusions: This research is the first to explore the impact of ayahuasca on suicidality. The findings suggest that ayahuasca may show potential as an intervention for suicidality. We highlight important limitations of the study, potential mechanisms, and future directions for research on ayahuasca as an intervention for suicidality. www.ClinicalTrials.gov, identifier NCT02914769.
自杀是一个重大的公共卫生问题。鉴于自杀率不断上升以及当前干预措施存在的局限性,迫切需要针对自杀倾向采取创新干预措施。尽管已表明死藤水可针对与自杀倾向相关的心理健康问题(即抑郁和绝望),但研究尚未探讨死藤水对自杀倾向的影响。因此,我们对一项随机安慰剂对照试验进行了二次分析,该试验中,难治性抑郁症患者被给予一剂死藤水(n = 14)或安慰剂(n = 15)。由一名经过培训的精神科医生在基线时以及干预后1天、2天和7天对自杀倾向进行评估。使用固定效应线性混合模型以及组间和组内的科恩效应量来检查自杀倾向的变化。在控制基线自杀倾向的情况下,我们发现时间有显著影响(p <.05)。干预(即死藤水与安慰剂)的效果有趋于显著的趋势(p =.088)。在所有时间点,我们发现组间效应量中等(即死藤水与安慰剂;第1天科恩d = 0.58;第2天d = 0.56;第7天d = 0.67),以及组内(死藤水;第1天科恩d = 1.33;第2天d = 1.42;第7天d = 1.19)效应量较大,表明自杀倾向有所降低。结论:本研究首次探讨了死藤水对自杀倾向的影响。研究结果表明,死藤水可能显示出作为自杀倾向干预措施的潜力。我们强调了该研究的重要局限性、潜在机制以及将死藤水作为自杀倾向干预措施的未来研究方向。ClinicalTrials.gov网站,标识符NCT02914769。