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评估裸盖菇素在减轻癌症患者痛苦方面的有效性:一项系统综述。

Evaluating the effectiveness of psilocybin in alleviating distress among cancer patients: A systematic review.

作者信息

Lapid Maria I, Pagali Sandeep R, Randall Andrea L, Donovan Kristine A, Bronars Carrie A, Gauthier Trevor A, Bock Jonathan, Lim Samantha D, Carey Elise C, Sokolowski Elizabeth, Ulrich Angela M, Hassett Leslie C, Kung Simon, Whitford Kevin J, Olivier Kenneth R, D'Andre Stacy D

机构信息

Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.

Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, Rochester, MN, USA.

出版信息

Palliat Support Care. 2025 Apr 22;23:e99. doi: 10.1017/S147895152500032X.

Abstract

OBJECTIVES

Psychological and existential distress is prevalent among patients with life-threatening cancer, significantly impacting their quality of life. Psilocybin-assisted therapy has shown promise in alleviating these symptoms. This systematic review aims to synthesize the evidence on the efficacy and safety of psilocybin in reducing cancer-related distress.

METHODS

We searched MEDLINE, APA PsycINFO, Cochrane database, Embase, and Scopus from inception to February 8, 2024, for randomized controlled trials (RCTs), open-label trials, qualitative studies, and single case reports that evaluated psilocybin for cancer-related distress. Data were extracted on study characteristics, participant demographics, psilocybin and psychotherapy intervention, outcome measures, and results. Two authors independently screened, selected, and extracted data from the studies. Cochrane Risk of Bias for RCTs and Methodological Index for Non-Randomized Studies criteria were used to evaluate study quality. This study was registered with PROSPERO (CRD42024511692).

RESULTS

Fourteen studies met the inclusion criteria, comprising three RCTs, five open-label trials, five qualitative studies, and one single case report. Psilocybin therapy consistently showed significant reductions in depression, anxiety, and existential distress, with improvements sustained over several months. Adverse effects were generally mild and transient.

SIGNIFICANCE OF RESULTS

This systematic review highlights the potential of psilocybin-assisted therapy as an effective treatment for reducing psychological and existential distress in cancer patients. Despite promising findings, further large-scale, well-designed RCTs are needed to confirm these results and address existing research gaps.

摘要

目的

心理和存在性困扰在患有危及生命癌症的患者中普遍存在,严重影响他们的生活质量。裸盖菇素辅助治疗已显示出缓解这些症状的前景。本系统评价旨在综合关于裸盖菇素在减轻癌症相关困扰方面的疗效和安全性的证据。

方法

我们检索了MEDLINE、美国心理学会心理学文摘数据库、考克兰数据库、Embase和Scopus,检索时间从各数据库建库至2024年2月8日,以查找评估裸盖菇素治疗癌症相关困扰的随机对照试验(RCT)、开放标签试验、定性研究和单病例报告。提取了有关研究特征、参与者人口统计学、裸盖菇素和心理治疗干预、结局指标及结果的数据。两位作者独立筛选、选择并从研究中提取数据。采用考克兰随机对照试验偏倚风险评估标准和非随机研究方法学指标标准来评估研究质量。本研究已在国际前瞻性系统评价注册库(PROSPERO,注册号:CRD42024511692)登记。

结果

14项研究符合纳入标准,包括3项随机对照试验、5项开放标签试验、5项定性研究和1项单病例报告。裸盖菇素治疗始终显示出抑郁、焦虑和存在性困扰显著减轻,且改善情况持续数月。不良反应一般较轻且为短暂性。

结果的意义

本系统评价突出了裸盖菇素辅助治疗作为减轻癌症患者心理和存在性困扰的有效治疗方法的潜力。尽管有这些有前景的发现,但仍需要进一步开展大规模、设计良好的随机对照试验来证实这些结果并填补现有研究空白。

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