van Elk Michiel, Fried Eiko I
Cognitive Psychology Unit, Institute of Psychology, Leiden University, PO Box 9555, Leiden 2300 RB, The Netherlands.
Clinical Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.
Ther Adv Psychopharmacol. 2023 Sep 25;13:20451253231198466. doi: 10.1177/20451253231198466. eCollection 2023.
Research in the last decade has expressed considerable optimism about the clinical potential of psychedelics for the treatment of mental disorders. This optimism is reflected in an increase in research papers, investments by pharmaceutical companies, patents, media coverage, as well as political and legislative changes. However, psychedelic science is facing serious challenges that threaten the validity of core findings and raise doubt regarding clinical efficacy and safety. In this paper, we introduce the 10 most pressing challenges, grouped into easy, moderate, and hard problems. We show how these problems threaten internal validity (treatment effects are due to factors unrelated to the treatment), external validity (lack of generalizability), construct validity (unclear working mechanism), or statistical conclusion validity (conclusions do not follow from the data and methods). These problems tend to co-occur in psychedelic studies, limiting conclusions that can be drawn about the safety and efficacy of psychedelic therapy. We provide a roadmap for tackling these challenges and share a checklist that researchers, journalists, funders, policymakers, and other stakeholders can use to assess the quality of psychedelic science. Addressing today's problems is necessary to find out whether the optimism regarding the therapeutic potential of psychedelics has been warranted and to avoid history repeating itself.
过去十年的研究对迷幻药治疗精神障碍的临床潜力表现出了相当大的乐观态度。这种乐观情绪体现在研究论文数量的增加、制药公司的投资、专利、媒体报道以及政治和立法变革上。然而,迷幻药科学正面临着严峻挑战,这些挑战威胁到核心研究结果的有效性,并引发了对临床疗效和安全性的质疑。在本文中,我们介绍了10个最紧迫的挑战,分为简单、中等和困难问题。我们展示了这些问题如何威胁到内部效度(治疗效果是由与治疗无关的因素导致的)、外部效度(缺乏普遍性)、结构效度(工作机制不明确)或统计结论效度(结论并非从数据和方法中得出)。这些问题在迷幻药研究中往往同时出现,限制了我们对迷幻药疗法安全性和有效性所能得出的结论。我们提供了应对这些挑战的路线图,并分享了一份清单,研究人员、记者、资助者、政策制定者和其他利益相关者可以用它来评估迷幻药科学的质量。解决当今的问题对于弄清楚对迷幻药治疗潜力的乐观态度是否合理以及避免历史重演是必要的。