Joshua Kugel, Ruben E Laukkonen, David B Yaden, Murat Yücel, Paul Liknaitzky
{"title":"Insights on Psychedelics: A Systematic Review of Therapeutic Effects.","authors":"Joshua Kugel, Ruben E Laukkonen, David B Yaden, Murat Yücel, Paul Liknaitzky","doi":"10.1016/j.neubiorev.2025.106117","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Insight - a sudden change in understanding or perspective that feels true or reliable - is a common occurrence during psychedelic experiences, and often considered by clinicians and patients to be central to their therapeutic value. However, their occurrence and role has not been systematically assessed.</p><p><strong>Objectives: </strong>We reviewed all peer-reviewed studies that published data on insight catalysed by a classic psychedelic at psychoactive levels, to elucidate several aspects of psychedelic-catalysed insight, including its prevalence, relationship to dose, time-course, and relationship to therapeutic outcomes. Risk of bias was assessed regarding selection, reliability, causality, and transparency. PROSPERO registration: CRD42023405854 FINDINGS: The final database and key bibliography searches were completed on July 13, 2024. We screened 741 abstracts and included 98 studies (40 survey, 58 interventional). Insight was positively correlated with psychedelic dose, and was significantly higher following psychedelics in 43 of 46 (93%) studies that presented a comparison to a placebo condition. Crucially, 25 of 29 studies (86%) found that insight was associated with therapeutic improvement, and this relationship was often stronger than mystical-type experience, which has received more research attention.</p><p><strong>Interpretation: </strong>This review indicates that psychedelic-catalysed insight is associated with therapeutic improvement, suggesting its importance for clinical practice and for understanding the mechanisms of psychedelic therapy.</p><p><strong>Limitations: </strong>Heterogeneous study designs and operationalisations of insight precluded a meta-analytic summary. Publication bias and selective reporting is possible, given insight was typically not a primary outcome of the included studies.</p><p><strong>Funding: </strong>This study was not supported by any external funding.</p>","PeriodicalId":56105,"journal":{"name":"Neuroscience and Biobehavioral Reviews","volume":" ","pages":"106117"},"PeriodicalIF":7.5000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroscience and Biobehavioral Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.neubiorev.2025.106117","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"BEHAVIORAL SCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Insight - a sudden change in understanding or perspective that feels true or reliable - is a common occurrence during psychedelic experiences, and often considered by clinicians and patients to be central to their therapeutic value. However, their occurrence and role has not been systematically assessed.
Objectives: We reviewed all peer-reviewed studies that published data on insight catalysed by a classic psychedelic at psychoactive levels, to elucidate several aspects of psychedelic-catalysed insight, including its prevalence, relationship to dose, time-course, and relationship to therapeutic outcomes. Risk of bias was assessed regarding selection, reliability, causality, and transparency. PROSPERO registration: CRD42023405854 FINDINGS: The final database and key bibliography searches were completed on July 13, 2024. We screened 741 abstracts and included 98 studies (40 survey, 58 interventional). Insight was positively correlated with psychedelic dose, and was significantly higher following psychedelics in 43 of 46 (93%) studies that presented a comparison to a placebo condition. Crucially, 25 of 29 studies (86%) found that insight was associated with therapeutic improvement, and this relationship was often stronger than mystical-type experience, which has received more research attention.
Interpretation: This review indicates that psychedelic-catalysed insight is associated with therapeutic improvement, suggesting its importance for clinical practice and for understanding the mechanisms of psychedelic therapy.
Limitations: Heterogeneous study designs and operationalisations of insight precluded a meta-analytic summary. Publication bias and selective reporting is possible, given insight was typically not a primary outcome of the included studies.
Funding: This study was not supported by any external funding.
期刊介绍:
The official journal of the International Behavioral Neuroscience Society publishes original and significant review articles that explore the intersection between neuroscience and the study of psychological processes and behavior. The journal also welcomes articles that primarily focus on psychological processes and behavior, as long as they have relevance to one or more areas of neuroscience.