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Mental health
Magic mushroom compound performs at least as well as leading antidepressant in small study
Psilocybe cyanescens mushrooms, which contain the active compound, psilocybin.CREDIT Imperial College London / Thomas Angus
Psilocybin, the active compound in magic mushrooms, may be at least as effective as a leading antidepressant medication in a therapeutic setting.
This is the finding of a study carried out by researchers at the Centre for Psychedelic Research at Imperial College London.
In the most rigorous trial to date assessing the therapeutic potential of a ‘psychedelic’ compound, researchers compared two sessions of psilocybin therapy with a six-week course of a leading antidepressant (a selective serotonin uptake inhibitor called escitalopram) in 59 people with moderate-to-severe depression.
The results, published today in the New England Journal of Medicine, show that while depression scores were reduced in both groups, the reductions occurred more quickly in the psilocybin group and were greater in magnitude.
However, the researchers caution that the main comparison between psilocybin and the antidepressant was not statistically significant. They add that larger trials with more patients over a longer period are needed to show if psilocybin can perform as well as, or more effectively than an established antidepressant.
For the psilocybin dosing sessions, volunteers received an oral dose of the drug in a specialist clinical setting, while they listened to a curated music playlist and were guided through their experiences by a psychological support team, which included registered psychiatrists. All volunteers on the study received the same level of psychological support.
People treated with psilocybin – named ‘COMP360’ by its developers, COMPASS Pathways PLC – showed marked improvements across a range of subjective measures, including in their ability to feel pleasure, and express emotions, greater reductions in anxiety and suicidal ideation, and increased feelings of wellbeing.
Dr Robin Carhart-Harris, head of the Centre for Psychedelic Research at Imperial, who designed and led the study, said: “These results comparing two doses of psilocybin therapy with 43 daily doses of one of the best performing SSRI antidepressants help contextualise psilocybin’s promise as a potential mental health treatment. Remission rates were twice as high in the psilocybin group than the escitalopram group.
“One of the most important aspects of this work is that people can clearly see the promise of properly delivered psilocybin therapy by viewing it compared with a more familiar, established treatment in the same study. Psilocybin performed very favourably in this head-to-head.”
GROWING EVIDENCE
During the study, 59 volunteers with moderate-to-severe depression received either a high dose of psilocybin and a placebo, or a very low dose of psilocybin and escitalopram.
In the psilocybin arm of the trial, 30 people received an initial dose of psilocybin (25mg) at the start of the study, followed by a second dose (25mg) three weeks later. They were given six weeks of daily placebo capsules to take: one per day after the first dosing session, increasing to two per day after the second dosing session.
In the escitalopram arm of the study, 29 people received 1mg psilocybin at the dosing sessions – a dose so low as to be classed as a non-active and unlikely to have an effect. They were also given six weeks of daily escitalopram: one 10mg capsule per day after the first dosing session, increasing to two per day after the second dosing session (20mg per day) – the maximum dose for this SSRI.
All participants were assessed using standardised scales of depressive symptom severity. The main measure, the QIDS-SR-16, was used to gauge depressive symptoms on a continuous scale ranging from 0-27, where higher scores indicate greater depression. At the start of the trial, the mean score was 14.5 for the psilocybin group. But after six weeks, scores reduced by an average of 8.0 points.
Response, defined as a reduction in depression scores from baseline of at least 50%, was seen in 70% of people in the psilocybin group, compared with 48% in the escitalopram group. In addition, remission of symptoms – measured as a score of 0-5 at week six – was seen in 57% of the psilocybin group, compared with just 28% in the escitalopram group.
ENCOURAGING FINDINGS
The team highlights that while the findings are generally positive, the absence of a straight placebo group and the small number of participants limits conclusions about the effect of either treatment alone. They add that the trial sample was comprised of largely white, majority male, and relatively well-educated individuals, which limits extrapolations to more diverse populations.
The psilocybin group reported fewer cases of dry mouth, anxiety, drowsiness and sexual dysfunction than the escitalopram group, and a similar rate of adverse events overall. Headaches experienced one day after dosing sessions were the most common side effect of psilocybin.
Dr Rosalind Watts, clinical lead of the trial and formerly based at the Centre for Psychedelic Research, said: “Context is crucial for these studies and all volunteers received therapy during and after their psilocybin sessions. Our team of therapists were on hand to offer full support through sometimes difficult emotional experiences.”
Professor David Nutt, principal investigator on the study and the Edmond J Safra Chair in Neuropsychopharmacology at Imperial, said: “These findings provide further support for the growing evidence base that shows that in people with depression, psilocybin offers an alternative treatment to traditional antidepressants.
“In our study, psilocybin worked faster than escitalopram and was well tolerated, with a very different adverse effects profile. We look forward to further trials, which if positive should lead to psilocybin becoming a licensed medicine.”
URGING CAUTION
The authors warn that while the initial findings are encouraging, patients with depression should not attempt to self-medicate with psilocybin, as the team provided a special clinical and therapeutic context for the drug experience and a regulated dose formulated in laboratory conditions. They stress that taking magic mushrooms or psilocybin in the absence of these careful safeguards might not have a positive outcome.
Dr Carhart-Harris, added: “These latest finding build on our previous research testing psilocybin therapy for treatment resistant depression, and offer the most compelling evidence yet to support efforts towards licensing psilocybin therapy as a regulated mental health intervention. I’m deeply grateful for the philanthropic support that made this trial possible.”
“I strongly encourage both researchers and the public to delve deeply into our results, including those available as a published appendix to the main report.”
Mental health conditions alarmingly high among children with autism
Nearly 78 per cent of children with autism have at least one mental health condition and nearly half have two mental health conditions or more, according to a new U.S. study from the University of British Columbia’s department of psychology and the AJ Drexel Autism Institute at Drexel University (Pennsylvania).
The study also found mental health conditions present in 44.8 per cent of pre-school age children with autism. The scope of the issue among that age group had not previously been established using a large, population-based sample.
By contrast, the study found that only 14.1 per cent of youth without autism (ages 3-17) had mental health conditions.
It is the first research since 2008 to examine the prevalence of mental health conditions among children with autism at a population level, and signals a need for healthcare systems to adapt to account for the overlap.
“For a long time, mental health in kids with autism was neglected because the focus was on autism. There’s much greater awareness now, but we don’t have enough people trained to provide mental health treatments to kids on the autism spectrum,” said Dr. Connor Kerns, an assistant professor in UBC’s psychology department and lead author of the study. “We need to bridge these two systems and the different sets of providers that tend to treat these children.”
Autism, or autism spectrum disorder (ASD), is a complex brain development disorder that impacts approximately 2.6 per cent of the U.S. population. People with autism can have difficulty communicating and interacting socially. They often demonstrate restricted, repetitive behaviour patterns. The term “spectrum” reflects the fact that symptoms can vary widely from one person to the next.
The researchers analyzed data from the 2016 National Survey of Children’s Health, a survey of more than 42,000 caregivers with a total of 1,131 ASD-diagnosed children in their care.
These children were considered to also have a mental health condition if the parent/caregiver had reported a healthcare provider diagnosing the child with any of the following:
- anxiety (39.5%)
- depression (15.7%)
- behavior/conduct problem (60.8%)
- Tourette syndrome (1.8%)
- ADHD (48.4%)
Mental health conditions became more prevalent as children with autism grew older. Still, the 44.8-per-cent prevalence among pre-school children is significant because early intervention is known to increase the effectiveness of mental health treatment.
The study compared the prevalence of mental health conditions in children with ASD, children with intellectual disabilities, and children with other ongoing, chronic conditions that require attention from the healthcare system. Mental health conditions were significantly more prevalent among children with autism than among the other groups.
For example, anxiety was 6.3 times more prevalent among children with autism than among children with intellectual disabilities, and three times more prevalent than it was among children with other special healthcare needs.
“There’s something specific about autism that is increasing this mental health burden, and it’s true not only for anxiety, but also for depression, behaviour problems and attention problems. This is a special population that requires special attention,” said Dr. Kerns.
The researchers hope these eye-opening new numbers will prompt changes to public policy that make it easier for mental health treatments to be approved and funded for children with autism.
“If we think about ways to screen and intervene against these mental health conditions before these children even get to school, then we might be way ahead of the game,” said Dr. Kerns. “The longer mental health conditions are allowed to exist and worsen, the harder they are going to be to treat. It’s much better to catch them early. Right now, we don’t have a great system for doing that.”
Need to reduce work-related stress? It’s a walk in the park
Study from the University of Tsukuba finds that taking regular walks in forests and greenspaces may be connected with workers’ stress-coping abilities
Work causes so much stress that it’s become a global public health issue. Stress’s impact on mental and physical health can also hurt productivity and result in economic loss. A new study now finds that working people who regularly take walks in forests or greenspaces may have higher stress-coping abilities.
In a study published in Public Health in Practice, researchers led by Professor Shinichiro Sasahara at the University of Tsukuba analyzed workers’ “sense of coherence” (SOC) scores, demographic attributes, and their forest/greenspace walking habits. SOC comprises the triad of meaningfulness (finding a sense of meaning in life), comprehensibility (recognizing and understanding stress), and manageability (feeling equipped to deal with stress). Studies have found factors such as higher education and being married can strengthen SOC, while smoking and not exercising can weaken it. People with strong SOC also have greater resilience to stress.
The study used survey data on more than 6,000 Japanese workers between 20 and 60 years old. It found stronger SOC among people who regularly took walks in forests or greenspaces.
“SOC indicates mental capacities for realizing and dealing with stress,” Professor Sasahara says. “With workplace stress as a focal issue, there’s a clear benefit in identifying everyday activities that raise SOC. It seems we may have found one.”
People find comfort in nature, and in countries like Japan urban greenspaces are increasing in popularity where nature isn’t readily accessible. This means many workers in cities can easily take a walk among the trees.
The researchers divided the survey respondents into four groups based on their frequency of forest/greenspace walking. Then, they compared their walking activity against attributes such as age, income, and marital status, and with the respondents’ SOC scores, which were grouped as weak, middle, and strong.
Those with strong SOC showed a significant correlation with both forest and greenspace walking at least once a week. This key finding implies the greater benefits of urban greening–not just environmental, but also socioeconomic.
“Our study suggests that taking a walk at least once a week in a forest or greenspace can help people have stronger SOC,” explains Professor Sasahara. “Forest/greenspace walking is a simple activity that needs no special equipment or training. It could be a very good habit for improving mental health and managing stress.”
In pandemic, people are turning to nature – especially women
One of the first studies of its kind finds significant increases in outdoor activity during COVID-19, especially among women. Women were 1.7 (gardening) to 2.9 (walking) times more likely to report increasing their outdoor activity than men. Outdoor activities seeing the largest increases were: watching wildlife (up 64%), gardening (57%), taking photos or doing other art in nature (54%), relaxing alone outside (58%), and walking (70%). Joshua Brown/University of Vermont
Spotting horned owls in neighborhood trees? Raising a bumper crop of winter squash? You may have much in common with individuals in a new study.
People in the study–who ranged from stuck at home to stressed in essential worker jobs–reported significant increases in outdoor activity during COVID-19, especially among women.
Outdoor activities seeing the largest increases were: watching wildlife (up 64%), gardening (57%), taking photos or doing other art in nature (54%), relaxing alone outside (58%), and, yes, making their masked and distanced way on walks (70%).
People also experienced a shift in why they value nature. During the pandemic, respondents said in nature they cherished a greater sense of mental health and wellbeing (59%), exercise (29%), appreciating nature’s beauty (29%), sense of identity (23%) and spirituality (22%), along with other less common values.
The Vermont research is one of the first published studies to explore how the COVID-19 pandemic has affected Americans’ relationship with nature.
“These data are like a treasure chest of the pandemic moment: a record of how people have been thinking about their relationship with the rest of the world in a time of great upheaval,” says Rachelle Gould of the University of Vermont, the study’s senior author.
The research is the first of two UVM studies being published this week by PLOS ONE on nature and COVID-19.
Key differences across groups
Not everyone experienced more nature equally. Differences were tied to factors including gender, income and employment, and whether people lived in urban or rural areas.
Women increased their nature use in more ways than men. Across the six most common nature activities in the study, women were 1.7 (gardening) to 2.9 (walking) times more likely to report increasing their engagement than men. Men were not more likely than women to report increased engagement in any activities.
While the study advances our understanding of gender differences during COVID-19, the researchers plan to inspect this finding further. They wonder if women had a greater need for stress relief during the pandemic, and are potentially more likely than men to turn to nature for that.
“More research is needed, but our preliminary analysis suggests that, during the pandemic, women are more likely than men to report increased importance of values that includes mental well-being, beauty, exercise, familiarity with landscape, and fun,” says Gould. “Our next step is to explore the qualitative data to explore this result deeper.”
Those who lost their jobs during the pandemic also had higher odds of reporting increased gardening, relaxing socially, walking, and wildlife watching. “This suggests that COVID-19 is overturning the idea that nature and its benefits–from stress reduction to social connection– are becoming ‘luxury goods,'” says Diana Hackenburg, a PhD candidate at the Rubenstein School, and a Gund Graduate Fellow.
Some groups valued tradition or food more and expressed those thoughts. With different results from urban and rural respondents, the researchers say there is more to learn behind the numbers, and plan future studies.
A first wave of COVID-19 research
Very few peer-reviewed studies have been published on the issue of Americans visiting nature during the pandemic, despite media reports and personal experience that suggest it is happening. This study, plus a UVM study that finds a large increase in new nature users, join recent study from Rice et al. and another from Norway among the among the first, globally. The study is further unique because it explores not only changes in activities, but also people’s values towards nature.
The team hopes decision makers can learn more about which populations are using nature more or less during the pandemic, “and focus on removing barriers to nature access, to increase equity,” says Joshua Morse, lead author, a PhD candidate at the Rubenstein School, and a Gund Graduate Fellow.
While many studies have explored how natural disasters (volcanoes, tornadoes, fires) impact human values, UVM researchers wanted to investigate a different type of crisis–a pandemic, which differs in key ways from other “natural disasters.”
Of the 15 outdoor activities studied, some went down in frequency – including camping – while other activities stayed relatively constant, including biking, boating, and fishing.
“Our work catalogues a part of this pandemic that might otherwise be under-discussed or hard to provide evidence for,” says Gould, an assistant professor in UVM’s Rubenstein School of Environment and Natural Resources and faculty fellow in the Gund Institute for Environment.
In addition to Prof. Gould and Morse, study authors include PhD candidates Diana Hackenburg and Tatiana Gladkikh, both Gund Graduate Fellows in the Rubenstein School. This research is one of six COVID projects launched by the Gund Institute for the Environment.
“This study is a timely snapshot of the central role nature plays in our well-being, and how important access to nature is during challenging, uncertain times like this pandemic,” says Gladkikh. “I hope the results help inform future land management decisions.”
The data resulted from online surveys of over 3,200 people in Vermont during the state’s “Stay safe, stay home” executive order, announced in May 2020.