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      Psychedelics, Mystical Experience, and Therapeutic Efficacy: A Systematic Review


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          The mystical experience is a potential psychological mechanism to influence outcome in psychedelic therapy. It includes features such as oceanic boundlessness, ego dissolution, and universal interconnectedness, which have been closely linked to both symptom reduction and improved quality of life. In this review, 12 studies of psychedelic therapy utilizing psilocybin, ayahuasca, or ketamine were analyzed for association between mystical experience and symptom reduction, in areas as diverse as cancer-related distress, substance use disorder, and depressive disorders to include treatment-resistant. Ten of the twelve established a significant association of correlation, mediation, and/or prediction. A majority of the studies are limited, however, by their small sample size and lack of diversity (gender, ethnic, racial, educational, and socioeconomic), common in this newly re-emerging field. Further, 6 out of 12 studies were open-label in design and therefore susceptible to bias. Future studies of this nature should consider a larger sample size with greater diversity and thus representation by use of randomized design. More in-depth exploration into the nature of mystical experience is needed, including predictors of intensity, in order to maximize its positive effects on treatment outcome benefits and minimize concomitant anxiety.

          Systematic Review Registration: PROSPERO, identifier CRD42021261752.

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          Most cited references53

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          RoB 2: a revised tool for assessing risk of bias in randomised trials

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            The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.

            Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement--a reporting guideline published in 1999--there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
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              Acceptance and commitment therapy: model, processes and outcomes.

              The present article presents and reviews the model of psychopathology and treatment underlying Acceptance and Commitment Therapy (ACT). ACT is unusual in that it is linked to a comprehensive active basic research program on the nature of human language and cognition (Relational Frame Theory), echoing back to an earlier era of behavior therapy in which clinical treatments were consciously based on basic behavioral principles. The evidence from correlational, component, process of change, and outcome comparisons relevant to the model are broadly supportive, but the literature is not mature and many questions have not yet been examined. What evidence is available suggests that ACT works through different processes than active treatment comparisons, including traditional Cognitive-Behavior Therapy (CBT). There are not enough well-controlled studies to conclude that ACT is generally more effective than other active treatments across the range of problems examined, but so far the data are promising.

                Author and article information

                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                12 July 2022
                : 13
                : 917199
                [1] 1Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London , London, United Kingdom
                [2] 2National Institute for Health Research Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London , London, United Kingdom
                [3] 3South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital , Beckenham, United Kingdom
                Author notes

                Edited by: Felix Mayer, Florida Atlantic University, United States

                Reviewed by: Natasha Leigh Mason, Maastricht University, Netherlands; Martin Desseilles, University of Namur, Belgium

                *Correspondence: Kwonmok Ko kwon.ko@ 123456kcl.ac.uk

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

                Copyright © 2022 Ko, Knight, Rucker and Cleare.

                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.

                : 10 April 2022
                : 08 June 2022
                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 53, Pages: 12, Words: 8123
                Systematic Review

                Clinical Psychology & Psychiatry
                psychedelic therapy,mystical experience,psilocybin,ayahuasca,ketamine,cancer-related distress,substance use disorder (sud),depressive disorders


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