Barba Tommaso, Buehler Sarah, Kettner Hannes, Radu Caterina, Cunha Bruna Giribaldi, Nutt David J, Erritzoe David, Roseman Leor, Carhart-Harris Robin
Centre for Psychedelic Research, Department of Medicine, Imperial College London, UK.
Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, USA.
BJPsych Open. 2022 Sep 6;8(5):e163. doi: 10.1192/bjo.2022.565.
Major depressive disorder is often associated with maladaptive coping strategies, including rumination and thought suppression.
To assess the comparative effect of the selective serotonin reuptake inhibitor escitalopram, and the serotonergic psychedelic psilocybin (COMP360), on rumination and thought suppression in major depressive disorder.
Based on data derived from a randomised clinical trial ( = 59), we performed exploratory analyses on the impact of escitalopram versus psilocybin (i.e. condition) on rumination and thought suppression from 1 week before to 6 weeks after treatment inception (i.e. time), using mixed analysis of variance. Condition responder versus non-responder subgroup analyses were also done, using the standard definition of ≥50% symptom reduction.
A time×condition interaction was found for rumination (F(1, 56) = 4.58, = 0.037) and thought suppression (F(1,57) = 5.88, = 0.019), with tests revealing significant decreases exclusively in the psilocybin condition. When analysing via response, a significant time×condition×response interaction for thought suppression (F(1,54) = 8.42, = 0.005) and a significant time×response interaction for rumination (F(1,54) = 23.50, < 0.001) were evident. Follow-up tests revealed that decreased thought suppression was exclusive to psilocybin responders, whereas rumination decreased in both responder groups. In the psilocybin arm, decreases in rumination and thought suppression correlated with ego dissolution and session-linked psychological insight.
These data provide further evidence on the therapeutic mechanisms of psilocybin and escitalopram in the treatment of depression.
重度抑郁症常与适应不良的应对策略相关，包括沉思和思维抑制。
评估选择性5-羟色胺再摄取抑制剂艾司西酞普兰和血清素能迷幻剂裸盖菇素（COMP360）对重度抑郁症患者沉思和思维抑制的比较效果。
基于一项随机临床试验（n = 59）的数据，我们采用混合方差分析，对治疗开始前1周到治疗开始后6周期间（即时间），艾司西酞普兰与裸盖菇素（即治疗条件）对沉思和思维抑制的影响进行了探索性分析。还使用症状减轻≥50%的标准定义进行了治疗条件反应者与无反应者亚组分析。
发现沉思（F(1, 56) = 4.58，P = 0.037）和思维抑制（F(1,57) = 5.88，P = 0.019）存在时间×治疗条件交互作用，t检验显示仅在裸盖菇素治疗条件下有显著下降。通过反应进行分析时，思维抑制存在显著的时间×治疗条件×反应交互作用（F(1,54) = 8.42，P = 0.005），沉思存在显著的时间×反应交互作用（F(1,54) = 23.50，P < 0.001）。后续检验显示，思维抑制的下降仅见于裸盖菇素反应者，而两个反应者组的沉思均下降。在裸盖菇素治疗组中，沉思和思维抑制的下降与自我解体和与治疗疗程相关的心理洞察相关。
这些数据为裸盖菇素和艾司西酞普兰治疗抑郁症的治疗机制提供了进一步证据。
