Stanley Wong, Gray Meckling, Nicholas Fabiano, Sanghun Lee, Brett D M Jones, Risa Shorr, Aroldo Dargel, Alan K Davis, Jess G Fiedorowicz, Marco Solmi, Joshua D Rosenblat, Benoit H Mulsant, Daniel M Blumberger, Muhammad Ishrat Husain
{"title":"裸盖菇素治疗对精神病患者自杀意念、企图和死亡的影响：系统回顾和荟萃分析","authors":"Stanley Wong, Gray Meckling, Nicholas Fabiano, Sanghun Lee, Brett D M Jones, Risa Shorr, Aroldo Dargel, Alan K Davis, Jess G Fiedorowicz, Marco Solmi, Joshua D Rosenblat, Benoit H Mulsant, Daniel M Blumberger, Muhammad Ishrat Husain","doi":"10.1177/20451253251372449","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Suicidal ideation, attempts, and deaths present a major and tragic public health concern. Recent trials of psilocybin therapy (PT) have shown promise in treating treatment-resistant depression and have found a reduction in suicidal ideation. Given the growth of PT research, there is a need to further understand its effect on suicidal ideation, attempts, and deaths.</p><p><strong>Objective: </strong>To assess and synthesize evidence on the effects of PT on suicidal ideation, attempts, and deaths in psychiatric patients.</p><p><strong>Design: </strong>PRISMA-compliant systematic review and meta-analysis.</p><p><strong>Data source: </strong>MEDLINE, EMBASE, Cochrane, and PsychINFO.</p><p><strong>Method: </strong>Databases were searched for randomized controlled trials of PT in adults with psychiatric diagnoses that reported suicide outcomes (ideation, attempts, and deaths). Abstract and full-text screening were conducted, and suicide outcomes were extracted. Meta-analysis was performed with a random effects model to assess changes in suicide outcomes compared to control through the standardized mean difference (SMD). Assessment of heterogeneity, risk of bias, and subgroup analysis was completed.</p><p><strong>Results: </strong>Nine studies were included (<i>N</i> = 593; 335 psilocybin & 258 control). Two studies were excluded from meta-analysis because suicide-related outcomes data were not available. Participants with PT experienced a small and significant decrease in suicidal ideation compared to control (<i>k</i> = 7, SMD = -0.24, 95% CI -0.42 to -0.06, <i>p</i> = 0.008, <i>I</i> <sup>2</sup> = 0%). There was no publication bias found. Subgroup analysis found no significant differences between groups. No study reported suicide attempts or suicide deaths. Two studies had a high risk of bias.</p><p><strong>Conclusion: </strong>Psilocybin therapy may reduce suicidal ideation in adults with psychiatric diagnoses. Current studies are limited by small sample size, lack of follow-up data, and assessment of blinding.</p><p><strong>Trial registration: </strong>CRD42023445706.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"15 ","pages":"20451253251372449"},"PeriodicalIF":4.0000,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417673/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of psilocybin therapy on suicidal ideation, attempts, and deaths in people with psychiatric diagnoses: a systematic review and meta-analysis.\",\"authors\":\"Stanley Wong, Gray Meckling, Nicholas Fabiano, Sanghun Lee, Brett D M Jones, Risa Shorr, Aroldo Dargel, Alan K Davis, Jess G Fiedorowicz, Marco Solmi, Joshua D Rosenblat, Benoit H Mulsant, Daniel M Blumberger, Muhammad Ishrat Husain\",\"doi\":\"10.1177/20451253251372449\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Suicidal ideation, attempts, and deaths present a major and tragic public health concern. Recent trials of psilocybin therapy (PT) have shown promise in treating treatment-resistant depression and have found a reduction in suicidal ideation. Given the growth of PT research, there is a need to further understand its effect on suicidal ideation, attempts, and deaths.</p><p><strong>Objective: </strong>To assess and synthesize evidence on the effects of PT on suicidal ideation, attempts, and deaths in psychiatric patients.</p><p><strong>Design: </strong>PRISMA-compliant systematic review and meta-analysis.</p><p><strong>Data source: </strong>MEDLINE, EMBASE, Cochrane, and PsychINFO.</p><p><strong>Method: </strong>Databases were searched for randomized controlled trials of PT in adults with psychiatric diagnoses that reported suicide outcomes (ideation, attempts, and deaths). Abstract and full-text screening were conducted, and suicide outcomes were extracted. Meta-analysis was performed with a random effects model to assess changes in suicide outcomes compared to control through the standardized mean difference (SMD). Assessment of heterogeneity, risk of bias, and subgroup analysis was completed.</p><p><strong>Results: </strong>Nine studies were included (<i>N</i> = 593; 335 psilocybin & 258 control). Two studies were excluded from meta-analysis because suicide-related outcomes data were not available. Participants with PT experienced a small and significant decrease in suicidal ideation compared to control (<i>k</i> = 7, SMD = -0.24, 95% CI -0.42 to -0.06, <i>p</i> = 0.008, <i>I</i> <sup>2</sup> = 0%). There was no publication bias found. Subgroup analysis found no significant differences between groups. No study reported suicide attempts or suicide deaths. Two studies had a high risk of bias.</p><p><strong>Conclusion: </strong>Psilocybin therapy may reduce suicidal ideation in adults with psychiatric diagnoses. Current studies are limited by small sample size, lack of follow-up data, and assessment of blinding.</p><p><strong>Trial registration: </strong>CRD42023445706.</p>\",\"PeriodicalId\":23127,\"journal\":{\"name\":\"Therapeutic Advances in Psychopharmacology\",\"volume\":\"15 \",\"pages\":\"20451253251372449\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-09-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417673/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Psychopharmacology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/20451253251372449\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Psychopharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/20451253251372449","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Effect of psilocybin therapy on suicidal ideation, attempts, and deaths in people with psychiatric diagnoses: a systematic review and meta-analysis.
Background: Suicidal ideation, attempts, and deaths present a major and tragic public health concern. Recent trials of psilocybin therapy (PT) have shown promise in treating treatment-resistant depression and have found a reduction in suicidal ideation. Given the growth of PT research, there is a need to further understand its effect on suicidal ideation, attempts, and deaths.
Objective: To assess and synthesize evidence on the effects of PT on suicidal ideation, attempts, and deaths in psychiatric patients.
Design: PRISMA-compliant systematic review and meta-analysis.
Data source: MEDLINE, EMBASE, Cochrane, and PsychINFO.
Method: Databases were searched for randomized controlled trials of PT in adults with psychiatric diagnoses that reported suicide outcomes (ideation, attempts, and deaths). Abstract and full-text screening were conducted, and suicide outcomes were extracted. Meta-analysis was performed with a random effects model to assess changes in suicide outcomes compared to control through the standardized mean difference (SMD). Assessment of heterogeneity, risk of bias, and subgroup analysis was completed.
Results: Nine studies were included (N = 593; 335 psilocybin & 258 control). Two studies were excluded from meta-analysis because suicide-related outcomes data were not available. Participants with PT experienced a small and significant decrease in suicidal ideation compared to control (k = 7, SMD = -0.24, 95% CI -0.42 to -0.06, p = 0.008, I2 = 0%). There was no publication bias found. Subgroup analysis found no significant differences between groups. No study reported suicide attempts or suicide deaths. Two studies had a high risk of bias.
Conclusion: Psilocybin therapy may reduce suicidal ideation in adults with psychiatric diagnoses. Current studies are limited by small sample size, lack of follow-up data, and assessment of blinding.
期刊介绍：
Therapeutic Advances in Psychopharmacology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of psychopharmacology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in psychopharmacology, providing a forum in print and online for publishing the highest quality articles in this area.
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