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      Association between mystical-type experiences under psychedelics and improvements in well-being or mental health – A comprehensive review of the evidence

      review-article
      * ,
      Journal of Psychedelic Studies
      Akadémiai Kiadó
      mystical experience, well-being, mental health, psychedelics

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          Abstract

          Background and aims

          Ingestion or administration of classic psychedelics is sometimes associated with improvements in well-being or mental health. Acute mystical-type experiences that psychedelics occasion have been suggested to be related to such improvements. Meanwhile, other features of the psychedelic experience, such as psychological insights and emotional breakthroughs, are also increasingly being studied. This review aimed to collect and assess the available evidence for mystical-type experiences under psychedelics associating with medium-to-long term improvements in well-being or mental health, on their own and as compared with other features of the acute experience.

          Methods

          I conducted a pre-registered, comprehensive review of existing empirical studies on the topic, based on a systematic search of the literature.

          Results

          Forty-four eligible studies were found, with most reporting positive associations between mystical-type experiences and improvements in well-being or mental health. The current level of evidence appeared stronger among healthy people, in cross-sectional studies, and for links with positive changes in general well-being and life satisfaction, attitudes and behavior, and anxiety, than for depression or other aspects of well-being and mental health. A few studies suggested that psychological insights and emotional breakthroughs may be as or more closely associated with positive changes than mystical-type experiences.

          Conclusions

          Despite their significant limitations, the identified studies suggest that mystical-type experiences under psychedelics are associated with improvements in some areas of well-being. However, psychological insights and emotional breakthroughs might be at least as important and should also be measured in future studies.

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          Most cited references80

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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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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              Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance.

              Although psilocybin has been used for centuries for religious purposes, little is known scientifically about its acute and persisting effects. This double-blind study evaluated the acute and longer-term psychological effects of a high dose of psilocybin relative to a comparison compound administered under comfortable, supportive conditions. The participants were hallucinogen-naïve adults reporting regular participation in religious or spiritual activities. Two or three sessions were conducted at 2-month intervals. Thirty volunteers received orally administered psilocybin (30 mg/70 kg) and methylphenidate hydrochloride (40 mg/70 kg) in counterbalanced order. To obscure the study design, six additional volunteers received methylphenidate in the first two sessions and unblinded psilocybin in a third session. The 8-h sessions were conducted individually. Volunteers were encouraged to close their eyes and direct their attention inward. Study monitors rated volunteers' behavior during sessions. Volunteers completed questionnaires assessing drug effects and mystical experience immediately after and 2 months after sessions. Community observers rated changes in the volunteer's attitudes and behavior. Psilocybin produced a range of acute perceptual changes, subjective experiences, and labile moods including anxiety. Psilocybin also increased measures of mystical experience. At 2 months, the volunteers rated the psilocybin experience as having substantial personal meaning and spiritual significance and attributed to the experience sustained positive changes in attitudes and behavior consistent with changes rated by community observers. When administered under supportive conditions, psilocybin occasioned experiences similar to spontaneously occurring mystical experiences. The ability to occasion such experiences prospectively will allow rigorous scientific investigations of their causes and consequences.
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                Author and article information

                Contributors
                Journal
                2054
                Journal of Psychedelic Studies
                JPS
                Akadémiai Kiadó (Budapest )
                2559-9283
                03 March 2023
                27 April 2023
                : 7
                : 1
                : 18-28
                Affiliations
                [1] Faculty of Social Sciences / Psychology, Tampere University , Tampere, Finland
                Author notes
                [* ]Corresponding author. Faculty of Social Sciences / Psychology, FI-33014 Tampere University , Finland. E-mail: samuli@ 123456kangaslampi.net
                Author information
                https://orcid.org/0000-0002-0480-9806
                Article
                10.1556/2054.2023.00243
                c0f37c94-95a7-4b7b-89b5-2658a0b47276
                © 2023 The Author(s)

                Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 04 November 2022
                : 10 January 2023
                : 10 January 2023
                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 62, Pages: 11

                Evolutionary Biology,Medicine,Psychology,Educational research & Statistics,Social & Behavioral Sciences
                psychedelics,mystical experience,well-being,mental health

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