Ko Kwonmok, Knight Gemma, Rucker James J, Cleare Anthony J
Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
National Institute for Health Research Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, United Kingdom.
Front Psychiatry. 2022 Jul 12;13:917199. doi: 10.3389/fpsyt.2022.917199. eCollection 2022.
The mystical experience is a potential psychological mechanism to influence outcome in psychedelic therapy. It includes features such as oceanic boundlessness, ego dissolution, and universal interconnectedness, which have been closely linked to both symptom reduction and improved quality of life. In this review, 12 studies of psychedelic therapy utilizing psilocybin, ayahuasca, or ketamine were analyzed for association between mystical experience and symptom reduction, in areas as diverse as cancer-related distress, substance use disorder, and depressive disorders to include treatment-resistant. Ten of the twelve established a significant association of correlation, mediation, and/or prediction. A majority of the studies are limited, however, by their small sample size and lack of diversity (gender, ethnic, racial, educational, and socioeconomic), common in this newly re-emerging field. Further, 6 out of 12 studies were open-label in design and therefore susceptible to bias. Future studies of this nature should consider a larger sample size with greater diversity and thus representation by use of randomized design. More in-depth exploration into the nature of mystical experience is needed, including predictors of intensity, in order to maximize its positive effects on treatment outcome benefits and minimize concomitant anxiety. PROSPERO, identifier CRD42021261752.
神秘体验是影响迷幻疗法疗效的一种潜在心理机制。它包括诸如海洋般的无限感、自我消融和普遍的相互联系等特征，这些特征与症状减轻和生活质量改善都密切相关。在本综述中，对12项使用裸盖菇素、死藤水或氯胺酮的迷幻疗法研究进行了分析，以探讨神秘体验与症状减轻之间的关联，涉及的领域包括癌症相关困扰、物质使用障碍和抑郁症（包括难治性抑郁症）等多个方面。12项研究中有10项建立了显著的相关性、中介作用和/或预测关联。然而，大多数研究存在样本量小和缺乏多样性（性别、种族、民族、教育程度和社会经济地位等方面）的局限性，这在这个新出现的领域很常见。此外，12项研究中有6项设计为开放标签，因此容易产生偏差。此类未来研究应考虑采用更大样本量且具有更高多样性、进而能通过随机设计实现代表性的研究。需要对神秘体验的本质进行更深入的探索，包括强度的预测因素，以便最大化其对治疗效果的积极影响并最小化伴随的焦虑。国际系统评价前瞻性注册库，标识符CRD42021261752。
