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裸盖菇素辅助团体心理治疗+基于正念的减压疗法(MBSR)治疗一线医护人员新冠疫情相关抑郁和职业倦怠:一项随机临床试验

Psilocybin-Assisted Group Psychotherapy + Mindfulness Based Stress Reduction (MBSR) for Frontline Healthcare Provider COVID-19 Related Depression and Burnout: A Randomized Clinical Trial.

作者信息

Lewis Benjamin R, Hendrick John, Byrne Kevin, Odette Madeleine, Wu Chaorong, Garland Eric L

机构信息

Associate Professor of Psychiatry, Huntsman Mental Health Institute, University of Utah.

Assistant Professor Department of Internal Medicine, Section of Palliative Medicine, University of Utah, and George E Whalen Veterans Affairs Hospital, Geriatrics Extended Care.

出版信息

medRxiv. 2025 Jan 1:2024.12.31.24319806. doi: 10.1101/2024.12.31.24319806.

Abstract

OBJECTIVE

This clinical trial sought to evaluate the safety and preliminary efficacy of psilocybin and MBSR for frontline healthcare providers with symptoms of depression and burnout related to the COVID-19 pandemic.

METHODS

This was a randomized controlled trial that enrolled physicians and nurses with frontline clinical work during the COVID-19 pandemic and symptoms of depression and burnout. Participants were randomized in a 1:1 ratio to either an 8-week MBSR curriculum alone or an 8-week MBSR curriculum plus group psilocybin-assisted psychotherapy (PAP) with 25mg psilocybin. Symptoms of depression and burnout were assessed at baseline, and 2-weeks and 6-months post intervention utilizing the Quick Inventory of Depressive Symptoms (QIDS-SR-16) and Maslach Burnout Inventory Human Services Survey for Medical Professionals (MBI-HSS-MP), respectively. Secondary outcome measures included the Demoralization Scale (DS-II) and the Watt's Connectedness Scale (WCS). Adverse events and suicidality were assessed through 6-month follow-up.

RESULTS

25 participants were enrolled and randomized. There were 12 study-related AEs recorded that were Grade 1-2 and no serious AEs. There was larger decrease in QIDS score for the MBSR+PAP arm compared to MBSR-only from baseline to 2-weeks post-intervention and significant between-group differences favoring MBSR+PAP on subscales of the MBI-HSS-MP as well as the DS-II and WCS.

CONCLUSIONS

Group psilocybin-assisted therapy plus MBSR was associated with clinically significant improvement in depressive symptoms without serious adverse events and with greater reduction in symptoms than MBSR alone. Study findings suggest that integrating psilocybin with mindfulness training may represent a promising treatment for depression and burnout among physicians and nurses.

摘要

目的

本临床试验旨在评估裸盖菇素和正念减压疗法(MBSR)对有与COVID-19大流行相关的抑郁和职业倦怠症状的一线医护人员的安全性和初步疗效。

方法

这是一项随机对照试验,纳入了在COVID-19大流行期间从事一线临床工作且有抑郁和职业倦怠症状的医生和护士。参与者按1:1的比例随机分为单独接受为期8周的MBSR课程组或接受为期8周的MBSR课程加25毫克裸盖菇素辅助团体心理治疗(PAP)组。分别在基线、干预后2周和6个月时,使用抑郁症状快速清单(QIDS-SR-16)和针对医学专业人员的马氏职业倦怠量表人类服务调查(MBI-HSS-MP)评估抑郁和职业倦怠症状。次要结局指标包括士气低落量表(DS-II)和瓦特联结量表(WCS)。通过6个月的随访评估不良事件和自杀倾向。

结果

25名参与者被纳入并随机分组。记录到12起与研究相关的1-2级不良事件,无严重不良事件。从基线到干预后2周,MBSR+PAP组的QIDS评分下降幅度大于仅接受MBSR组,并且在MBI-HSS-MP的子量表以及DS-II和WCS上,两组间存在显著差异,有利于MBSR+PAP组。

结论

团体裸盖菇素辅助治疗加MBSR与抑郁症状的临床显著改善相关,无严重不良事件,且症状减轻程度大于单独使用MBSR。研究结果表明,将裸盖菇素与正念训练相结合可能是治疗医生和护士抑郁和职业倦怠的一种有前景的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fa2/11722457/ec4829c0350c/nihpp-2024.12.31.24319806v1-f0001.jpg

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