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      Psychedelic replications in virtual reality and their potential as a therapeutic instrument: An open-label feasibility study

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          Abstract

          Background

          Recent research has shown promising results for the therapeutic benefits of psychedelics. One popular view claims that these benefits are mediated by the subjective experiences induced by these substances. Based on this, we designed a virtual reality experience, Psyrreal, that mimics the phenomenological components of psychedelic experiences.

          Aims

          We aimed to investigate the therapeutic efficacy of Psyrreal and psychedelic VR experiences in treating depressive symptoms as well as explore the effect of Psyrreal on subjective factors which have been suggested to mediate the therapeutic benefits of psychedelics.

          Methods

          In this open-label feasibility study, thirteen participants with mild-to-moderate depression underwent a 2-day therapeutic intervention implementing Psyrreal. Depressive symptoms were evaluated by the Emotional State Questionnaire (EST-Q2) at the start of the intervention and 2 weeks after. A thematic analysis of semi-structured interviews after Psyrreal was also conducted as an additional assessment of the method.

          Results

          A 2-day intervention implementing Psyrreal led to significant decreases in depressive symptoms at the 2-week follow-up ( n = 10, p = 0.007, Hedges’ g = 1.046) measured by the Emotional State Questionnaire (EST-Q2). The analysis of semi-structured interviews suggests that Psyrreal could lead to insight and alterations in the sense of self in some people.

          Conclusion

          This work proposes a novel method using virtual reality to augment the treatment of psychological disorders as well as to precisely investigate the mediating subjective factors of the therapeutic effects of psychedelic substances. Our preliminary results suggest that VR experiences combined with psychological support show potential in treating depressive symptoms and further research into similar methods is warranted.

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          Most cited references159

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          Using thematic analysis in psychology

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            G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences

            G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of the t, F, and chi2 test families. In addition, it includes power analyses for z tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.
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              Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial

              Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes. Trial Registration ClinicalTrials.gov identifier: NCT00465595
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                01 March 2023
                2023
                : 14
                : 1088896
                Affiliations
                [1] 1Institute of Computer Science, University of Tartu , Tartu, Estonia
                [2] 2Institute of Molecular and Cell Biology, University of Tartu , Tartu, Estonia
                Author notes

                Edited by: Jacob Aday, University of California, San Francisco, United States

                Reviewed by: Hannes Simon Kettner, Imperial College London, United Kingdom; Isabel Wießner, Federal University of Rio Grande do Norte, Brazil

                *Correspondence: Karl Kristjan Kaup, kaup.kristjan@ 123456gmail.com

                This article was submitted to Psychopharmacology, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2023.1088896
                10022432
                36937731
                a9e0e1fd-e582-4f98-adf0-57edb1ce9022
                Copyright © 2023 Kaup, Vasser, Tulver, Pikamäe and Aru.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 03 November 2022
                : 10 February 2023
                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 167, Pages: 14, Words: 12261
                Funding
                Funded by: Eesti Teadusagentuur, doi 10.13039/501100002301;
                Funded by: European Social Fund, doi 10.13039/501100004895;
                This research was supported by the European Social Fund through the IT Academy Programme and the Estonian Research Council grant PSG728.
                Categories
                Psychiatry
                Methods

                Clinical Psychology & Psychiatry
                psychedelics,virtual reality,therapy,therapeutic mechanisms of psychedelics,altered states of consciousness (asc),vr-augmented therapy,depression,depressive disorder

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