Haft Stephanie L, Downey Amanda E, Raymond-Flesch Marissa, Fernandes-Osterhold Gisele, Bradley Ellen R, O'Donovan Aoife, Woolley Joshua
University of California San Francisco, Department of Psychiatry and Behavioral Sciences, 675 18th Ave. San Francisco, CA 94121, USA.
University of California San Francisco, Department of Psychiatry and Behavioral Sciences, 675 18th Ave. San Francisco, CA 94121, USA; University of California San Francisco, Department of Pediatrics, 550 16th St. Box 0110, San Francisco, CA 94143, USA.
Psychiatry Res. 2025 Mar;345:116359. doi: 10.1016/j.psychres.2025.116359. Epub 2025 Jan 10.
A lack of diverse and representative participant samples in mental health intervention research perpetuates mental health disparities. This issue has become a salient concern in studies of psychedelic-assisted psychotherapy (PAT), which is emerging as a promising mental health intervention. This systematic review evaluates the reporting, representation, and analysis of participant sociodemographic characteristics in randomized controlled trials (RCTs) of PAT. A total of 21 RCTs of psilocybin- and 3,4-methylenedioxy methamphetamine (MDMA)-assisted therapies (N = 1034) are summarized. Participants' gender (100%) and race or ethnicity (76%) were frequently reported, with socioeconomic status (SES) sometimes (57%) reported using heterogeneous metrics. Sexual orientation (9.5%) and immigration status (4.8%) were rarely reported, and no studies reported gender identity. Compared to their representation in the US population and non-psychedelic clinical trials, Black/African-American participants (2.2%) and Hispanic/Latino participants (7.2%) were significantly underrepresented in PAT RCTs. MDMA trials enrolled more diverse participant samples than psilocybin trials. Analyses on treatment effects based on demographic variables were virtually nonexistent. These findings underscore the need for more inclusive recruitment strategies, along with more rigorous reporting, to improve the generalizability of PAT research.
心理健康干预研究中缺乏多样化和具有代表性的参与者样本，使得心理健康差距长期存在。这个问题在迷幻剂辅助心理治疗（PAT）的研究中已成为一个突出的关注点，PAT正成为一种有前景的心理健康干预方法。本系统评价评估了PAT随机对照试验（RCT）中参与者社会人口学特征的报告、代表性和分析情况。共总结了21项关于裸盖菇素和3,4-亚甲基二氧基甲基苯丙胺（摇头丸）辅助治疗的RCT（N = 1034）。参与者的性别（100%）和种族或族裔（76%）经常被报告，社会经济地位（SES）有时（57%）会使用不同的指标进行报告。性取向（9.5%）和移民身份（4.8%）很少被报告，且没有研究报告性别认同情况。与他们在美国人口和非迷幻剂临床试验中的代表性相比，黑人/非裔美国参与者（2.2%）和西班牙裔/拉丁裔参与者（7.2%）在PAT RCT中的代表性明显不足。摇头丸试验纳入的参与者样本比裸盖菇素试验更多样化。基于人口统计学变量的治疗效果分析几乎不存在。这些发现强调需要更具包容性的招募策略以及更严格的报告，以提高PAT研究的可推广性。
