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Garcia ACM, Maia LO, Meireles E, Nogueira DA, Tófoli LF. Spiritual Well-Being Among Users and Non-Users of Psychedelics: A Cross-Sectional Study. J Psychoactive Drugs 2023:1-10. [PMID: 37971325 DOI: 10.1080/02791072.2023.2284343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/29/2023] [Indexed: 11/19/2023]
Abstract
This study evaluated the psychometric properties of the Spiritual Well-Being Scale (SWBS) in a Brazilian sample. We analyzed spiritual well-being, defined as existential well-being (EWB) and religious well-being (RWB), among individuals with varying religious and spiritual experiences, both users and non-users of psychedelics. The online cross-sectional survey was conducted in Brazil, from April to June 2022. The psychometric analyses demonstrated reliability and validity based on the internal structure and the relationship with satisfactory external variables concerning the RWB and EWB factors of the SWBS. Validity evidence was shown for both factors (RWB, EWB) with adequate reliability ratings. However, the RWB factor, which was entirely replicated, demonstrated the best group differentiation and internal consistency. Although both factors showed validity, the RWB factor exhibited superior psychometric indices for validity, group discrimination, and reliability. Regarding psychedelics, the association with RWB and EWB demonstrates a U-shaped pattern, as participants who never use these substances typically exhibit higher RWB and EWB indices, succeeded by frequent users. This finding underscores the need for additional studies to further explore the intricate interplay between psychedelics and spiritual well-being.
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Affiliation(s)
- Ana Cláudia Mesquita Garcia
- Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas, Alfenas, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Lucas Oliveira Maia
- Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas, Alfenas, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Everson Meireles
- Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas, Alfenas, Brazil
- Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, BA, Brazil
| | - Denismar Alves Nogueira
- Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas, Alfenas, Brazil
- Institute of Exact Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil
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Cruz L, Bienemann B, Palhano-Fontes F, Tófoli LF, Araújo DB, Mograbi DC. A quantitative textual analysis of the subjective effects of ayahuasca in naïve users with and without depression. Sci Rep 2023; 13:19635. [PMID: 37949934 PMCID: PMC10638373 DOI: 10.1038/s41598-023-44193-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 11/12/2023] Open
Abstract
Ayahuasca is a brew with psychoactive properties that has been used as an entheogen for centuries, with more recent studies suggesting it is a promising treatment for some clinical disorders. Although there is an emerging scientific literature on its effects, to the best of our knowledge no study has explored the self-reported experiences of first-time ayahuasca users with quantitative textual analysis tools. Accordingly, the current study aimed to analyze the subjective experience of naive individuals with depression and healthy controls after consuming ayahuasca. For this purpose, responses from a subsample of participants from a previous clinical trial to open-ended questions regarding their experience with ayahuasca underwent textual analysis. Data from nine patients with treatment-resistant depression and 20 healthy individuals were included, and quantitative textual analysis was performed using IRaMuTeQ 0.7 alpha 2 and R 3.1.2. The analysis identified five clusters: alterations in the state of consciousness, cognitive changes, somatic alterations, auditory experiences, and visual perceptual content. Additionally, findings suggest specific features of the experience of people with depression with ayahuasca, such as increased aversive bodily reactions. The results are consistent with previous findings indicating central axes of the psychedelic experience, and may inform therapeutic approaches using ayahuasca.
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Affiliation(s)
- Lucas Cruz
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Bheatrix Bienemann
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | | | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Dráulio B Araújo
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil.
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, PO Box 078, London, UK.
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Ruffell SGD, Netzband N, Tsang W, Davies M, Inserra A, Butler M, Rucker JJH, Tófoli LF, Dempster EL, Young AH, Morgan CJA. Corrigendum: Ceremonial ayahuasca in amazonian retreats-mental health and epigenetic outcomes from a six-month naturalistic study. Front Psychiatry 2023; 14:1304503. [PMID: 37904854 PMCID: PMC10613463 DOI: 10.3389/fpsyt.2023.1304503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2021.687615.].
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Affiliation(s)
- Simon G. D. Ruffell
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Nige Netzband
- Department of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - WaiFung Tsang
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Merlin Davies
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Matthew Butler
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - James J. H. Rucker
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), University of Campinas, São Paulo, Brazil
| | - Emma Louise Dempster
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Celia J. A. Morgan
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
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Wießner I, Falchi M, Palhano-Fontes F, Feilding A, Ribeiro S, Tófoli LF. LSD, madness and healing: Mystical experiences as possible link between psychosis model and therapy model. Psychol Med 2023; 53:1151-1165. [PMID: 34253268 DOI: 10.1017/s0033291721002531] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND For a century, psychedelics have been investigated as models of psychosis for demonstrating phenomenological similarities with psychotic experiences and as therapeutic models for treating depression, anxiety, and substance use disorders. This study sought to explore this paradoxical relationship connecting key parameters of the psychotic experience, psychotherapy, and psychedelic experience. METHODS In a randomized, double-blind, placebo-controlled, crossover design, 24 healthy volunteers received 50 μg d-lysergic acid diethylamide (LSD) or inactive placebo. Psychotic experience was assessed by aberrant salience (Aberrant Salience Inventory, ASI), therapeutic potential by suggestibility (Creative Imagination Scale, CIS) and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ; Mindful Attention Awareness Scale, MAAS; Experiences Questionnaire, EQ), and psychedelic experience by four questionnaires (Altered State of Consciousness Questionnaire, ASC; Mystical Experiences Questionnaire, MEQ; Challenging Experiences Questionnaire, CEQ; Ego-Dissolution Inventory, EDI). Relationships between LSD-induced effects were examined. RESULTS LSD induced psychedelic experiences, including alteration of consciousness, mystical experiences, ego-dissolution, and mildly challenging experiences, increased aberrant salience and suggestibility, but not mindfulness. LSD-induced aberrant salience correlated highly with complex imagery, mystical experiences, and ego-dissolution. LSD-induced suggestibility correlated with no other effects. Individual mindfulness changes correlated with aspects of aberrant salience and psychedelic experience. CONCLUSIONS The LSD state resembles a psychotic experience and offers a tool for healing. The link between psychosis model and therapeutic model seems to lie in mystical experiences. The results point to the importance of meaning attribution for the LSD psychosis model and indicate that psychedelic-assisted therapy might benefit from therapeutic suggestions fostering mystical experiences.
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Affiliation(s)
- Isabel Wießner
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Marcelo Falchi
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Sidarta Ribeiro
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Luís Fernando Tófoli
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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5
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Wießner I, Falchi M, Daldegan-Bueno D, Palhano-Fontes F, Olivieri R, Feilding A, B Araujo D, Ribeiro S, Bezerra Mota N, Tófoli LF. LSD and language: Decreased structural connectivity, increased semantic similarity, changed vocabulary in healthy individuals. Eur Neuropsychopharmacol 2023; 68:89-104. [PMID: 36669231 DOI: 10.1016/j.euroneuro.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023]
Abstract
Language has been explored as a window into the mind. Psychedelics, known to affect perception and cognition, seem to change language, but a systematic, time-dependent exploration is lacking. Therefore, we aimed at mapping the psychedelic effects on language over the time course of the acute and sub-acute effects in an explorative manner. For this, 24 healthy volunteers (age [mean±SD, range]: 35±11, 25-61 years; 33% women) received 50 μg lysergic acid diethylamide (LSD) or inactive placebo in a randomized, double-blind, placebo-controlled, crossover study. We assessed different language productions (experience reporting, storytelling), components (structure, semantics, vocabulary) and time points (+0 h to +24 h). Language productions included 5-min experience reporting (+1.5 h, +6.5 h) and 1-min storytelling (+0 h, +2 h, +4 h, +6 h, +24 h). Language structure was assessed by computing speech topology (SpeechGraphs), semantics by semantic distances (FastText), vocabulary by word categories (LIWC). LSD, compared to placebo, changed language structure, including decreased verbosity, lexicon, global and local connectivity (+1.5 h to +4 h); decreased semantic distances between neighbouring words and overall words (+2 h to +24 h); and changed vocabulary related to grammar, persons, time, space and biological processes (+1.5 h to +24 h). In conclusion, low to moderate LSD doses changed language over diverse production types, components and time points. While simpler and disconnected structure and semantic similarity might reflect cognitive impairments, changed vocabulary might reflect subjective perceptions. Therefore, language under LSD might provide a window into the psychedelic mind and automated language quantifications should be better explored as valuable tools to yield more unconstrained insights into psychedelic perception and cognition.
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Affiliation(s)
- Isabel Wießner
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, São Paulo, Brazil; Brain Institute, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho 3000, Lagoa Nova, 59078-900, Natal, Rio Grande do Norte, Brazil.
| | - Marcelo Falchi
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, São Paulo, Brazil; Brain Institute, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho 3000, Lagoa Nova, 59078-900, Natal, Rio Grande do Norte, Brazil
| | - Dimitri Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, São Paulo, Brazil; Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho 3000, Lagoa Nova, 59078-900, Natal, Rio Grande do Norte, Brazil
| | - Rodolfo Olivieri
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, São Paulo, Brazil
| | - Amanda Feilding
- The Beckley Foundation, Beckley Park, Oxford, United Kingdom
| | - Draulio B Araujo
- Brain Institute, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho 3000, Lagoa Nova, 59078-900, Natal, Rio Grande do Norte, Brazil
| | - Sidarta Ribeiro
- Brain Institute, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho 3000, Lagoa Nova, 59078-900, Natal, Rio Grande do Norte, Brazil
| | - Natália Bezerra Mota
- Department of Psychiatry and Forensic Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, São Paulo, Brazil.
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6
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Pontual AADD, Tófoli LF, Corradi-Webster CM, van Oorsouw K, Delgado ARO, Ramaekers JG. The influence of ceremonial settings on mystical and challenging experiences occasioned by ayahuasca: A survey among ritualistic and religious ayahuasca users. Front Psychol 2022; 13:857372. [PMID: 35911023 PMCID: PMC9335152 DOI: 10.3389/fpsyg.2022.857372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
Recent studies have recognized the importance of non-pharmacological factors such as setting to induce or promote mystical experiences or challenging experiences among ayahuasca users. This study aimed to evaluate the association between the setting in which ayahuasca is consumed and the intensity of mystical and challenging experiences considering three ayahuasca using traditions (União do Vegetal, Santo Daime and neo-shamanic groups). A cross-sectional analysis was performed on survey data collected online from 2,751 participants. The Setting Questionnaire for the Ayahuasca Experience (SQAE) was used to evaluate six dimensions of the setting characteristics. The Mystical Experience Questionnaire (MEQ) and the Challenging Experience Questionnaire (CEQ) were used to quantify the psychedelic experience. Ratings on every SQAE setting dimension were negatively correlated with ratings of the CEQ (r values between 0.21 and 0.36) for all ayahuasca using traditions. Regression analysis revealed that ratings on four SQAE dimensions (Social, Comfort, Infrastructure and Decoration) explained 41% of the variance in CEQ ratings. Associations between SQAE and MEQ ratings were relatively weak and confined to the dimensions Leadership and Comfort, explaining 14% of the variance in MEQ ratings. Ratings of Social context were higher among members of União do Vegetal compared to Santo Daime and neo-shamanic members. Ratings of Infrastructure, Comfort and Decoration were more consistently correlated with MEQ in the neoshamanic tradition compared to the other traditions. This study shows that the setting is an important moderator of a challenging experience under ayahuasca. Maximizing the quality of the setting in which ayahuasca is taken will reduce the chance of a challenging experience while contributing positively to a mystical experience. The present findings can be considered when designing rituals and the (social) environment of ayahuasca ceremonies, and indicate that the SQAE questionnaire can be employed to monitor the influence of ceremonial settings on the ayahuasca experience.
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Affiliation(s)
- Alexandre Augusto de Deus Pontual
- Department of Psychology, Faculty of Philosophy, Science and Letters, University of São Paulo, Ribeirão Preto, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
- *Correspondence: Alexandre Augusto de Deus Pontual,
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | | | - Kim van Oorsouw
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Alicia Raquel Osuna Delgado
- Department of Psychology, Faculty of Philosophy, Science and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - Johannes G. Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Wießner I, Falchi M, Palhano-Fontes F, Oliveira Maia L, Feilding A, Ribeiro S, Bezerra Mota N, Araujo DB, Tófoli LF. Low-dose LSD and the stream of thought: Increased Discontinuity of Mind, Deep Thoughts and abstract flow. Psychopharmacology (Berl) 2022; 239:1721-1733. [PMID: 34708255 DOI: 10.1007/s00213-021-06006-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 10/07/2021] [Indexed: 01/28/2023]
Abstract
RATIONALE Stream of thought describes the nature of the mind when it is freely roaming, a mental state that is continuous and highly dynamic as in mind-wandering or free association. Classic serotonergic psychedelics are known to profoundly impact perception, cognition and language, yet their influence on the stream of thought remains largely unexplored. OBJECTIVE To elucidate the effects of LSD on the stream of thought. METHODS In a randomized, double-blind, placebo-controlled, crossover study, 24 healthy participants received 50 μg lysergic acid diethylamide (LSD) or inactive placebo. Mind-wandering was measured by the Amsterdam Resting State Questionnaire (ARSQ), free association by the Forward Flow Task (FFT) for three seed word types (animals, objects, abstract words). ARSQ and FFT were assessed at +0 h, +2 h, +4 h, +6 h, +8 h and +24 h after drug administration, respectively. RESULTS LSD, compared to placebo, induced different facets of mind-wandering we conceptualized as "chaos" (Discontinuity of Mind, decreased Sleepiness, Planning, Thoughts under Control, Thoughts about Work and Thoughts about Past), "meaning" (Deep Thoughts, Not Sharing Thoughts) and "sensation" (Thoughts about Odours, Thoughts about Sounds). LSD increased the FFT for abstract words reflecting an "abstract flow" under free association. Overall, chaos was strongest pronounced (+2 h to +6 h), followed by meaning (+2 h to +4 h), sensation (+2 h) and abstract flow (+4 h). CONCLUSIONS LSD affects the stream of thought within several levels (active, passive), facets (chaos, meaning, sensation, abstractness) and time points (from +2 h to +6 h). Increased chaos, meaning and abstract flow at +4 h indicate the utility of a late therapeutic window in psycholytic therapy.
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Affiliation(s)
- Isabel Wießner
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, 13083-887, Brazil. .,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
| | - Marcelo Falchi
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, 13083-887, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Lucas Oliveira Maia
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, 13083-887, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | | | - Sidarta Ribeiro
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Natália Bezerra Mota
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.,Department of Physics, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Draulio B Araujo
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Luís Fernando Tófoli
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, Campinas, São Paulo, 13083-887, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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8
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Daldegan-Bueno D, Maia LO, Massarentti CM, Tófoli LF. Ayahuasca and tobacco smoking cessation: results from an online survey in Brazil. Psychopharmacology (Berl) 2022; 239:1767-1782. [PMID: 35179623 DOI: 10.1007/s00213-022-06063-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022]
Abstract
RATIONALE Smoking-related disease is a major problem globally. Effective smoking cessation treatments are however limited. Increasing evidence suggests that psychedelics have potential as treatments for substance use disorders and may therefore prove an option in aiding smoking cessation. OBJECTIVES To establish which factors predict smoking cessation in people who reported quitting or reducing smoking following ayahuasca consumption. METHODS A retrospective cross-sectional mixed-method study (quantitative and qualitative design) was undertaken using data from an online survey evaluating peoples' experiences before and after drinking ayahuasca. Multivariate logistic regression was performed with smoking condition (cessation or reduction/relapse) as a dependent variable and demographics, smoking, ayahuasca-related variables and the mystical experience (MEQ30) as predicting factors. RESULTS A total of 441 responses were grouped according to self-reported smoking status: cessation (n = 305) or reduction/relapse (n = 136) smoking. Logistic regression showed that mystical experience (OR: 1.03; 95% CI [1.00-1.05]) and frequency of ayahuasca intake (OR: 2.16[1.00-4.70]) were protective factors, while positive mood (measured by the MEQ30) during the ayahuasca experience was a risk factor (OR: 0.91[0.85-0.97]). Qualitative thematic analysis identified eight themes (e.g. acquired awareness, spiritual experience, increased motivation) related to the ayahuasca experience and the process of smoking cessation/reduction. CONCLUSIONS Our results suggest that ayahuasca could be used as a potential tool for smoking cessation, and that effects may be mediated by mystical experience. Given the current burden of smoking-related disease and the limited treatment options, studies are needed to investigate the efficacy of psychedelics in smoking cessation.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Lucas Oliveira Maia
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
| | - Carolina Marcolino Massarentti
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil.
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9
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de Deus Pontual AA, Senhorini HG, Corradi-Webster CM, Tófoli LF, Daldegan-Bueno D. Systematic Review of Psychometric Instruments Used in Research with Psychedelics. J Psychoactive Drugs 2022:1-10. [PMID: 35616606 DOI: 10.1080/02791072.2022.2079108] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There has been a revival of research that studies the subjective effects of psychedelic drugs on humans. Areas of health science have been studying their possible therapeutic benefits, and psychological measurement instruments are being developed as the studies progress. However, these instruments currently suffer criticism regarding their number and evidence of psychometric quality. This study aims to review which psychometric instruments are available to assess subjective states induced by psychedelics. We systematically searched five databases (Web of Science, Academic Search Premier, EMBASE, CINAHL and PubMed) using psychometrics and psychedelics related terms identifying studies published from 1990 to 2021. Of 857 articles generated from the systematic-search, fifteen met our criteria and were included in the review, evaluating nine instruments: MEQ, 5D-ASC, HRS, PSI, EDI, CEQ, EBI, EDI and PIQ. Eight dealing with phenomenological aspects of the psychedelic experience and one as a screening tool for psychotic or manic episode. The purpose of each instrument, the number of items in each version, the type of scale and their elaboration process were described. The number of instruments used in psychedelic research is growing steadily, but there are still many other parts of the psychedelic experience that lack measurement.
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Affiliation(s)
- Alexandre Augusto de Deus Pontual
- Department of Psychology, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - H G Senhorini
- Department of Psychology, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - C M Corradi-Webster
- Department of Psychology, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil
| | - L F Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - D Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas, Campinas, Brazil.,Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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10
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Wießner I, Olivieri R, Falchi M, Palhano-Fontes F, Oliveira Maia L, Feilding A, B Araujo D, Ribeiro S, Tófoli LF. LSD, afterglow and hangover: Increased episodic memory and verbal fluency, decreased cognitive flexibility. Eur Neuropsychopharmacol 2022; 58:7-19. [PMID: 35158230 DOI: 10.1016/j.euroneuro.2022.01.114] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/20/2022]
Abstract
Psychedelics acutely impair cognitive functions, but these impairments decline with growing experiences with psychedelics and microdoses may even exert opposing effects. Given the recent evidence that psychedelics induce neuroplasticity, this explorative study aimed at investigating the potential of psychedelics to sub-acutely change cognition. For this, we applied a randomized, double-blind, placebo-controlled, crossover study with 24 healthy volunteers receiving 50 μg lysergic acid diethylamide (LSD) or an inactive placebo. Sub-acute changes in cognition were measured 24 h after dosing, including memory (Rey-Osterrieth Complex Figure, ROCF; 2D Object-Location Memory Task, OLMT; Rey Auditory-Verbal Learning Test, RAVLT), verbal fluency (phonological; semantic; switch), design fluency (basic; filter; switch), cognitive flexibility (Wisconsin Card Sorting Test, WCST), sustained and switching attention (Trail Making Test, TMT), inhibitory control (Stroop Task) and perceptual reasoning (Block Design Test, BDT). The results show that when compared to placebo and corrected for Body Mass Index (BMI) and abstinence period from psychedelics, LSD sub-acutely improved visuospatial memory (ROCF immediate recall points and percentage, OLMT consolidation percentage) and phonological verbal fluency and impaired cognitive flexibility (WCST: fewer categories achieved; more perseveration, errors and conceptual level responses). In conclusion, the low dose of LSD moderately induced both "afterglow" and "hangover". The improvements in visuospatial memory and phonological fluency suggest that LSD-assisted therapy should be explored as a novel treatment perspective in conditions involving memory and language declines such as brain injury, stroke or dementia.
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Affiliation(s)
- Isabel Wießner
- Department of Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil; Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
| | - Rodolfo Olivieri
- Department of Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil; Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Marcelo Falchi
- Department of Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil; Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Lucas Oliveira Maia
- Department of Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil; Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Amanda Feilding
- The Beckley Foundation, Beckley Park, Oxford, United Kingdom
| | - Draulio B Araujo
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sidarta Ribeiro
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Luís Fernando Tófoli
- Department of Psychiatry, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil; Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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11
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Wießner I, Falchi M, Maia LO, Daldegan-Bueno D, Palhano-Fontes F, Mason NL, Ramaekers JG, Gross ME, Schooler JW, Feilding A, Ribeiro S, Araujo DB, Tófoli LF. LSD and creativity: Increased novelty and symbolic thinking, decreased utility and convergent thinking. J Psychopharmacol 2022; 36:348-359. [PMID: 35105186 DOI: 10.1177/02698811211069113] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Controversy surrounds psychedelics and their potential to boost creativity. To date, psychedelic studies lack a uniform conceptualization of creativity and methodologically rigorous designs. AIMS This study aimed at addressing previous issues by examining the effects of lysergic acid diethylamide (LSD) on creativity using multimodal tasks and multidimensional approaches. METHODS In a randomized, double-blind, placebo-controlled, crossover study, 24 healthy volunteers received 50 μg of LSD or inactive placebo. Near drug peak, a creativity task battery was applied, including pattern meaning task (PMT), alternate uses task (AUT), picture concept task (PCT), creative metaphors task (MET) and figural creativity task (FIG). Creativity was assessed by scoring creativity criteria (novelty, utility, surprise), calculating divergent thinking (fluency, originality, flexibility, elaboration) and convergent thinking, computing semantic distances (semantic spread, semantic steps) and searching for data-driven special features. RESULTS LSD, compared to placebo, changed several creativity measurements pointing to three overall LSD-induced phenomena: (1) 'pattern break', reflected by increased novelty, surprise, originality and semantic distances; (2) decreased 'organization', reflected by decreased utility, convergent thinking and, marginally, elaboration; and (3) 'meaning', reflected by increased symbolic thinking and ambiguity in the data-driven results. CONCLUSION LSD changed creativity across modalities and measurement approaches. Three phenomena of pattern break, disorganization and meaning seemed to fundamentally influence creative cognition and behaviour pointing to a shift of cognitive resources 'away from normal' and 'towards the new'. LSD-induced symbolic thinking might provide a tool to support treatment efficiency in psychedelic-assisted therapy.
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Affiliation(s)
- Isabel Wießner
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Marcelo Falchi
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Lucas Oliveira Maia
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Dimitri Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.,Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | | | - Natasha L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Madeleine E Gross
- Psychological and Brain Science Department, University of California, Santa Barbara, CA, USA
| | - Jonathan W Schooler
- Psychological and Brain Science Department, University of California, Santa Barbara, CA, USA
| | | | - Sidarta Ribeiro
- Brain Institute, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Draulio B Araujo
- Brain Institute, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Luís Fernando Tófoli
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
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12
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Bouso JC, Andión Ó, Sarris JJ, Scheidegger M, Tófoli LF, Opaleye ES, Schubert V, Perkins D. Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey. PLOS Glob Public Health 2022; 2:e0000438. [PMID: 36962494 PMCID: PMC10021266 DOI: 10.1371/journal.pgph.0000438] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 10/07/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Ayahuasca is a plant-based decoction native to Amazonia, where it has a long history of use in traditional medicine. Contemporary ritual use of ayahuasca has been expanding throughout the world for mental health purposes, and for spiritual and personal growth. Although researchers have been conducting clinical trials and observational studies reporting medical and psychological benefits, most of these do not report ayahuasca's immediate or medium-term adverse effects, so these are underrepresented in the literature. With the expansion of ayahuasca ceremonies from their traditional contexts to countries around the world, there is an important public health question regarding the risk/benefit balance of its use. METHODS We used data from an online Global Ayahuasca Survey (n = 10,836) collected between 2017 and 2019 involving participants from more than 50 countries. Principal component analysis was performed to assess group effects. Logistic regression analysis was performed to test for adverse effects associated with history of ayahuasca use, clinical, context of use and spiritual effect variables. RESULTS Acute physical health adverse effects (primarily vomiting) were reported by 69.9% of the sample, with 2.3% reporting the need for subsequent medical attention. Adverse mental health effects in the weeks or months following consumption were reported by 55.9% of the sample, however, around 88% considered such mental health effects as part of a positive process of growth or integration. Around 12% sought professional support for these effects. Physical adverse effects were related to older age at initial use of ayahuasca, having a physical health condition, higher lifetime and last year ayahuasca use, having a previous substance use disorder diagnosis, and taking ayahuasca in a non-supervised context. Mental health adverse effects were positively associated with anxiety disorders; physical health conditions; and the strength of the acute spiritual experience; and negatively associated with consumption in religious settings. CONCLUSIONS While there is a high rate of adverse physical effects and challenging psychological effects from using ayahuasca, they are not generally severe, and most ayahuasca ceremony attendees continue to attend ceremonies, suggesting they perceive the benefits as outweighing any adverse effects. Knowing what variables might predict eventual adverse effects may serve in screening of, or providing additional support for, vulnerable subjects. Improved understanding of the ayahuasca risk/benefit balance can also assist policy makers in decisions regarding potential regulation and public health responses.
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Affiliation(s)
- José Carlos Bouso
- International Center for Ethnobotanical Education, Research and Services (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center, Department of Anthropology, Philosophy and Social Work, University of Rovira I Virgili, Tarragona, Spain
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Óscar Andión
- Research Sherpas, Mieres (Olot), Sabadell, Spain
| | - Jerome J Sarris
- Psychae Institute, Melbourne, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
- Florey Institute of Neuroscience and Mental Health, The Melbourne Clinic Professorial Unit, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Milan Scheidegger
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil
| | | | - Violeta Schubert
- School of Social and Political Science, University of Melbourne, Melbourne, Australia
| | - Daniel Perkins
- Psychae Institute, Melbourne, Australia
- School of Social and Political Science, University of Melbourne, Melbourne, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Centre for Mental Health, Swinburne University, Melbourne, Australia
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13
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Daldegan-Bueno D, Favaro VM, Tófoli LF, Sussulini A, Cassas F, Oliveira MGM. Ayahuasca Lyophilization (Freeze-drying) Protocol with Pre- and Post-procedure Alkaloids Quantification. J Psychoactive Drugs 2021; 54:278-283. [PMID: 34530685 DOI: 10.1080/02791072.2021.1971342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Ayahuasca is a psychoactive brew from the decoction of different Amazonian plants, traditionally used in several cultures, religions, and rituals. Scientific studies with ayahuasca are rapidly increasing due to its subjective effects and therapeutic potential. Although ayahuasca is traditionally used in its liquid presentation, lyophilized (freeze-dried) ayahuasca is often used in scientific experimentation settings. However, there is no standard process or guideline to freeze-dry ayahuasca nor comparison of the chemical profile between the liquid and freeze-dried presentations. Therefore, we describe a reproducible five-day protocol for ayahuasca lyophilization with alkaloids quantification by liquid chromatography coupled to tandem mass spectrometry of both the liquid and the final freeze-dried ayahuasca. By the end of the protocol, approximately 295 g of freeze-dried extract with similar alkaloids concentration were obtained from two liters of ayahuasca (dry matter: 14.75 %). The final extract was stored for three years inside a vacuum desiccator (approximately 6°C) with its texture quality preserved. Further studies should address the impact of different storage conditions and the lyophilization on the alkaloids' quantity of the freeze-dried ayahuasca, especially the use of heat in regards to the β-carbolines.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Psychobiology, Federal University of São Paulo (Unifesp), São Paulo, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (Icaro), School of Medical Sciences, State University of Campinas (Unicamp), State University of Campinas, Campinas, Brazil
| | - Vanessa Manchim Favaro
- Department of Psychobiology, Federal University of São Paulo (Unifesp), São Paulo, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (Icaro), School of Medical Sciences, State University of Campinas (Unicamp), State University of Campinas, Campinas, Brazil.,Otto Richard Gottlieb Bioorganic Chemistry Lab (Labiorg), Institute of Environmental, Chemical and Pharmaceutical Sciences (Icaqf/unifesp), Chemistry Department, Federal University of São Paulo (Unifesp), São Paulo, Brazil
| | - Alessandra Sussulini
- Laboratory of Bioanalytics and Integrated Omics (Labiomics), Institute of Chemistry, State University of Campinas (Unicamp), Campinas, Brazil
| | - Fernando Cassas
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (Icaro), School of Medical Sciences, State University of Campinas (Unicamp), State University of Campinas, Campinas, Brazil.,Otto Richard Gottlieb Bioorganic Chemistry Lab (Labiorg), Institute of Environmental, Chemical and Pharmaceutical Sciences (Icaqf/unifesp), Chemistry Department, Federal University of São Paulo (Unifesp), São Paulo, Brazil
| | - Maria Gabriela Menezes Oliveira
- Department of Psychobiology, Federal University of São Paulo (Unifesp), São Paulo, Brazil.,Interdisciplinary Cooperation for Ayahuasca Research and Outreach (Icaro), School of Medical Sciences, State University of Campinas (Unicamp), State University of Campinas, Campinas, Brazil
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14
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Pontual AADD, Tófoli LF, Collares CF, Ramaekers JG, Corradi-Webster CM. The Setting Questionnaire for the Ayahuasca Experience: Questionnaire Development and Internal Structure. Front Psychol 2021; 12:679016. [PMID: 34248778 PMCID: PMC8260978 DOI: 10.3389/fpsyg.2021.679016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
The growing interest in research on psychedelic consumption in naturalistic contexts and their possible medical and therapeutic benefits requires assessment of the relationships between the substance and the individual who consumes it (set) and its context of use (setting). This study provides a novel measurement scale for the setting of Ayahuasca consumption, the Setting Questionnaire for the Ayahuasca Experience (SQAE), and examines its psychometric properties. Construction of the scale began with a literature review, followed by interviews on 19 Ayahuasca users from different backgrounds and different consumption experience, and an online survey for quantitative data collection (n = 2,994). Exploratory Graph Analysis (EGA) was used to investigate the questionnaire's dimensional structure with (n = 1,497, half of the sample), and multidimensional item response theory (MIRT) was used to compare the fit of the theoretical dimensions with the EGA proposed dimensions (n = 1,497, independent other half). EGA identified six dimensions, which corresponded partially to the theorized model (Leadership, Decoration, Infrastructure, Comfort, Instruction, and Social). The MIRT comparison found that the proposed theoretical model fit significantly better than the EGA model, providing support for the former (χ2/df = 1,967; CFI = 0,972; TLI = 0,969; RMSEA = 0,059; WRMR = 1,087). Our findings present evidence of validity of this instrument, justifying its use for future research on the influence of the setting during the ayahuasca experience. Its findings may provide a basis for expanding the settings investigated in the use of psychedelics in general.
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Affiliation(s)
- Alexandre Augusto de Deus Pontual
- Department of Psychology, Faculty of Philosophy, Science and Letters, University of São Paulo, Ribeirão Preto, Brazil
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Carlos Fernando Collares
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Johannes G. Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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15
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Ruffell SGD, Netzband N, Tsang W, Davies M, Inserra A, Butler M, Rucker JJH, Tófoli LF, Dempster EL, Young AH, Morgan CJA. Ceremonial Ayahuasca in Amazonian Retreats-Mental Health and Epigenetic Outcomes From a Six-Month Naturalistic Study. Front Psychiatry 2021; 12:687615. [PMID: 34177670 PMCID: PMC8221532 DOI: 10.3389/fpsyt.2021.687615] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/14/2021] [Indexed: 12/29/2022] Open
Abstract
Ayahuasca is a natural psychoactive brew, used in traditional ceremonies in the Amazon basin. Recent research has indicated that ayahuasca is pharmacologically safe and its use may be positively associated with improvements in psychiatric symptoms. The mechanistic effects of ayahuasca are yet to be fully established. In this prospective naturalistic study, 63 self-selected participants took part in ayahuasca ceremonies at a retreat centre in the Peruvian Amazon. Participants undertook the Beck Depression Inventory (BDI-II), State-Trait Anxiety Inventory (STAI), Self-compassion Scale (SCS), Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), as well as secondary measures, pre- and post-retreat and at 6-months. Participants also provided saliva samples for pre/post epigenetic analysis. Overall, a statistically significant decrease in BDI-II (13.9 vs. 6.1, p < 0.001), STAI (44.4 vs. 34.3 p < 0.001) scores, and CORE-OM scores were observed (37.3 vs. 22.3 p < 0.001) at post-retreat, as well as a concurrent increase in SCS (3.1 vs. 3.6, p < 0.001). Psychometric improvements were sustained, and on some measures values further decreased at 6-month follow-up, suggesting a potential for lasting therapeutic effects. Changes in memory valence were linked to the observed psychometric improvements. Epigenetic findings were equivocal, but indicated that further research in candidate genes, such as sigma non-opioid intracellular receptor 1 (SIGMAR1), is warranted. This data adds to the literature supporting ayahuasca's possible positive impact on mental health when conducted in a ceremonial context. Further investigation into clinical samples, as well as greater analyses into the mechanistic action of ayahuasca is advised.
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Affiliation(s)
- Simon G. D. Ruffell
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Nige Netzband
- Department of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - WaiFung Tsang
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Merlin Davies
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Matthew Butler
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - James J. H. Rucker
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), University of Campinas, São Paulo, Brazil
| | - Emma Louise Dempster
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Celia J. A. Morgan
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
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16
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Perkins D, Schubert V, Simonová H, Tófoli LF, Bouso JC, Horák M, Galvão-Coelho NL, Sarris J. Influence of Context and Setting on the Mental Health and Wellbeing Outcomes of Ayahuasca Drinkers: Results of a Large International Survey. Front Pharmacol 2021; 12:623979. [PMID: 33967757 PMCID: PMC8097729 DOI: 10.3389/fphar.2021.623979] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/22/2021] [Indexed: 01/16/2023] Open
Abstract
Ayahuasca is a traditional plant decoction containing N,N-dimethyltryptamine (DMT) and various β-carbolines including harmine, harmaline, and tetrahydroharmine, which has been used ceremonially by Amazonian Indigenous groups for healing and spiritual purposes. Use of the brew has now spread far beyond its original context of consumption to North America, Europe, and Australia in neo-shamanic settings as well as Christian syncretic churches. While these groups have established their own rituals and protocols to guide use, it remains unknown the extent to which the use of traditional or non-traditional practices may affect drinkers' acute experiences, and longer term wellbeing and mental health outcomes. Hence, this study aimed to provide the first detailed assessment of associations between ceremony/ritual characteristics, additional support practices, motivations for drinking, and mental health and wellbeing outcomes. The paper uses data from a large cross-sectional study of ayahuasca drinkers in more than 40 countries who had used ayahuasca in various contexts (n = 6,877). It captured detailed information about participant demographics, patterns and history of ayahuasca drinking, the setting of consumption, and ritualistic practices employed. Current mental health status was captured via the Kessler 10 psychological distress scale and the mental health component score of the SF-12 Health Questionnaire, while reported change in prior clinically diagnosed anxiety or depression (n = 1276) was evaluated using a (PGIC) Patient Global Impression of Change tool. Various intermediate outcomes were also assessed including perceived change in psychological wellbeing, number of personal self-insights attained, and subjective spiritual experience measured via the spirituality dimension of the Persisting Effects Questionnaire (PEQ) and Short Index of Mystical Orientation. Regression models identified a range of significant associations between set and setting variables, and intermediate and final mental health and wellbeing outcomes. A generalized structural equation model (GSEM) was then used to verify relationships and associations between endogenous, mediating and final outcome variables concurrently. The present study sheds new light on the influence of ceremonial practices, additional supports and motivations on the therapeutic effects of ayahuasca for mental health and wellbeing, and ways in which such factors can be optimized in naturalistic settings and clinical studies.
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Affiliation(s)
- Daniel Perkins
- School of Social and Political Science, University of Melbourne, Melbourne, VIC, Australia
| | - Violeta Schubert
- School of Social and Political Science, University of Melbourne, Melbourne, VIC, Australia
| | | | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - José Carlos Bouso
- International Center for Ethnobotanic Education, Research and Service (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Miroslav Horák
- Faculty of Regional Development and International Studies, Department of Languages and Cultural Studies, Mendel University in Brno, Brno, Czech Republic
| | - Nicole Leite Galvão-Coelho
- Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
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Sarris J, Perkins D, Cribb L, Schubert V, Opaleye E, Bouso JC, Scheidegger M, Aicher H, Simonova H, Horák M, Galvão-Coelho NL, Castle D, Tófoli LF. Ayahuasca use and reported effects on depression and anxiety symptoms: An international cross-sectional study of 11,912 consumers. Journal of Affective Disorders Reports 2021. [DOI: 10.1016/j.jadr.2021.100098] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Guimarães IC, Tófoli LF, Sussulini A. Determination of the Elemental Composition of Ayahuasca and Assessments Concerning Consumer Safety. Biol Trace Elem Res 2021; 199:1179-1184. [PMID: 32504397 DOI: 10.1007/s12011-020-02226-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/28/2020] [Indexed: 11/24/2022]
Abstract
The consumption of ayahuasca, a brew prepared from the decoction of two Amazon plants, has increased worldwide in the last decades. This fact raised questions about the safety in its oral administration. In this sense, information concerning the chemical composition of ayahuasca is essential to find a comprehensive reply. Therefore, the aim of this study consisted of determining the elemental composition of ready-to-consume ayahuasca samples produced in Brazil, in order to evaluate the safety in the oral administration of this beverage, considering recommended macroelement and microelement daily intake values and the permitted limits of potentially toxic heavy metals. Real ayahuasca samples, obtained from Brazilian religious groups, underwent microwave radiation-assisted acid decomposition, and Li, Al, Mn, Fe, Co, Cu, Zn, As, Cd, Hg, and Pb concentrations were determined by ICP-MS, while Ca, Mg, K, and P concentrations were determined by ICP OES. Method accuracy was assessed by analyte addition and recovery assays. Recoveries ranged from 80 and 118%, indicating satisfactory accuracy. Limit of detection (LOD) and limit of quantification (LOQ) values were lower than 1 mg L-1 for the macroelements determined by ICP OES and lower than 3.5 μg L-1 for the microelements determined by ICP-MS. The concentrations of the elements determined in the samples were lower than the recommended or tolerable limits; hence, it is possible to affirm that ayahuasca presents safe administration levels regarding total elemental content.
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Affiliation(s)
- Ivanilce Cristina Guimarães
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), P.O. Box 6154, Campinas, SP, 13083-970, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Alessandra Sussulini
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), P.O. Box 6154, Campinas, SP, 13083-970, Brazil.
- National Institute of Science and Technology for Bioanalytics - INCTBio, Institute of Chemistry, University of Campinas (UNICAMP), P.O. Box 6154, Campinas, SP, 13083-970, Brazil.
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Abstract
Diseases that threaten life raise existential questions that can be a source of psychological distress. Studies with psychedelics demonstrate therapeutic effects for anxiety and depression associated with life-threatening illnesses. Ayahuasca has been proposed as a possible therapeutic agent in the treatment of psychiatric disorders. Preliminary studies suggest that ayahuasca could promote therapeutic effects for people with physical illnesses. The aim of this study was to explore how the ritual use of ayahuasca during the treatment of severe physical illnesses (SPI) may influence the way people understand and relate to their illness, using qualitative methods to assess the participants' perspectives. Participants who consumed ayahuasca ritualistically during the period of treatment for SPI were purposely chosen. Data were obtained through semi-structured interviews. A thematic analysis was performed with 14 individuals. The ritual experience with ayahuasca acted on the participants' illness understanding through multiple psychological mechanisms, including introspection, self-analysis, emotional processing and catharsis, recall of autobiographical memories subjectively related to illness origin, illness resignification, and perspective changes. This study suggests that the experience with ayahuasca may facilitate illness acceptance through an influence on the meanings of the illness, life, and death. These changes may favor a more balanced relationship with illness and treatment.
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Affiliation(s)
- Lucas Oliveira Maia
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Dimitri Daldegan-Bueno
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Luís Fernando Tófoli
- Department of Medical Psychology and Psychiatry, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
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Pinheiro S, Mota NB, Sigman M, Fernández-Slezak D, Guerreiro A, Tófoli LF, Cecchi G, Copelli M, Ribeiro S. The History of Writing Reflects the Effects of Education on Discourse Structure: Implications for Literacy, Orality, Psychosis and the Axial Age. Trends Neurosci Educ 2020; 21:100142. [PMID: 33303107 DOI: 10.1016/j.tine.2020.100142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Graph analysis detects psychosis and literacy acquisition. Bronze Age literature has been proposed to contain childish or psychotic features, which would only have matured during the Axial Age (∼800-200 BC), a putative boundary for contemporary mentality. METHOD Graph analysis of literary texts spanning ∼4,500 years shows remarkable asymptotic changes over time. RESULTS While lexical diversity, long-range recurrence and graph length increase away from randomness, short-range recurrence declines towards random levels. Bronze Age texts are structurally similar to oral reports from literate typical children and literate psychotic adults, but distinct from poetry, and from narratives by preliterate preschoolers or Amerindians. Text structure reconstitutes the "arrow-of-time", converging to educated adult levels at the Axial Age onset. CONCLUSION The educational pathways of oral and literate traditions are structurally divergent, with a decreasing range of recurrence in the former, and an increasing range of recurrence in the latter. Education is seemingly the driving force underlying discourse maturation.
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Affiliation(s)
- Sylvia Pinheiro
- Instituto do Cérebro, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Natália Bezerra Mota
- Instituto do Cérebro, Universidade Federal do Rio Grande do Norte, Natal, Brazil.; Departamento de Física, Universidade Federal de Pernambuco, Recife, Brazil
| | - Mariano Sigman
- Laboratorio de Neurociencia, Universidad Torcuato Di Tella, Buenos Aires, Argentina.; CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas), Argentina.; Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Diego Fernández-Slezak
- Departamento de Computación, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina.; Instituto de Investigación en Ciencias de la Computación, CONICET, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Antonio Guerreiro
- Departamento de Antropologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Luís Fernando Tófoli
- Departamento de Psicologia Médica e Psiquiatria, Universidade Estadual de Campinas, Campinas, Brazil
| | - Guillermo Cecchi
- Computational Biology Center - Neuroscience, IBM T.J. Watson Research Center, Yorktown Heights, USA
| | - Mauro Copelli
- Departamento de Física, Universidade Federal de Pernambuco, Recife, Brazil..
| | - Sidarta Ribeiro
- Instituto do Cérebro, Universidade Federal do Rio Grande do Norte, Natal, Brazil..
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21
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Abstract
Traditional ayahuasca can be defined as a brew made from Amazonian vine Banisteriopsis caapi and Amazonian admixture plants. Ayahuasca is used by indigenous groups in Amazonia, as a sacrament in syncretic Brazilian religions, and in healing and spiritual ceremonies internationally. The study aimed to determine concentrations of the main bio- and psychoactive components of ayahuasca used in different locations and traditions. We collected 102 samples of brews from ayahuasca-using communities. Concentrations of N,N-dimethyltryptamine (DMT), tetrahydroharmine, harmine, and harmaline were determined by ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). Qualitative analyses for non-traditional additives (moclobemide, psilocin, yuremamine) were performed by high resolution mass spectrometry. Higher and more variable concentrations of DMT in neoshamanic ayahuasca samples compared to indigenous samples may indicate use of higher and more variable proportions of DMT-containing admixture plants. From European samples, we found two related samples of analog ayahuasca containing moclobemide, psilocin, DMT, yuremamine, and very low concentrations of B. caapi alkaloids. Some analogs of ayahuasca (Peganum harmala, Mimosa tenuiflora) were used in Europe. No analogs were found from Brazil or Santo Daime ceremonies in Europe. We recommend awareness about the constituents of the brew and ethical self-regulation among practitioners of ayahuasca ceremonies.
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Affiliation(s)
- Helle Kaasik
- School of Theology and Religious Studies; and Institute of Physics, University of Tartu, Tartu, Estonia
| | - Rita C Z Souza
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Flávia S Zandonadi
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Alessandra Sussulini
- Laboratory of Bioanalytics and Integrated Omics (LaBIOmics), Institute of Chemistry, University of Campinas (UNICAMP), Campinas, SP, Brazil
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Gomes-Medeiros D, Faria PHD, Campos GWDS, Tófoli LF. Drug policy and Collective Health: necessary dialogues. CAD SAUDE PUBLICA 2019; 35:e00242618. [PMID: 31365702 DOI: 10.1590/0102-311x00242618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/15/2019] [Indexed: 11/22/2022] Open
Abstract
The current status of policies on illicit drugs has implications for Collective Health that need to be discussed in depth. This essay aims to explore, in light of the best evidence, the public health impact of drug policies focused on the criminalization of growing, selling, and consuming psychoactive substances. Brazil provides the context for the main analysis. The principal points addressed in this work include drugs as a social issue and the definition of the prohibitionist paradigm, evidence of the unhealthy relationship between this paradigm and the population's health, the issue of a model of care for users of psychoactive substances focused on therapeutic communities, and future paths to be explored to overcome the prohibition of illicit drugs as the principal approach to the issue. Among the main problematic elements in the repressive approach in the Brazilian context, the study highlights violence and homicides, the health impacts of incarceration and blocked access to the health system, and potential new therapies derived from currently banned psychoactive substances. As proposals for future policy changes, the study highlights decriminalization of the use, possession, and small-scale sale of drugs; the reduction of the violence and discrimination associated with policing; focus on harm reduction policies; approach to gender-related specificities; and inclusion of social variables as metrics for successful treatment of problematic drug use. In conclusion, it is relevant that the social issue and drug policy have become the object of more studies in the field of Collective Health.
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Affiliation(s)
- Débora Gomes-Medeiros
- Laboratório de Estudos Interdisciplinares sobre Psicoativos, Campinas, Brasil.,Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil
| | - Pedro Henrique de Faria
- Laboratório de Estudos Interdisciplinares sobre Psicoativos, Campinas, Brasil.,Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil
| | | | - Luís Fernando Tófoli
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil
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Palhano-Fontes F, Barreto D, Onias H, Andrade KC, Novaes MM, Pessoa JA, Mota-Rolim SA, Osório FL, Sanches R, dos Santos RG, Tófoli LF, de Oliveira Silveira G, Yonamine M, Riba J, Santos FR, Silva-Junior AA, Alchieri JC, Galvão-Coelho NL, Lobão-Soares B, Hallak JEC, Arcoverde E, Maia-de-Oliveira JP, Araújo DB. Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial. Psychol Med 2019; 49:655-663. [PMID: 29903051 PMCID: PMC6378413 DOI: 10.1017/s0033291718001356] [Citation(s) in RCA: 364] [Impact Index Per Article: 72.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/16/2018] [Accepted: 04/24/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recent open-label trials show that psychedelics, such as ayahuasca, hold promise as fast-onset antidepressants in treatment-resistant depression. METHODS To test the antidepressant effects of ayahuasca, we conducted a parallel-arm, double-blind randomized placebo-controlled trial in 29 patients with treatment-resistant depression. Patients received a single dose of either ayahuasca or placebo. We assessed changes in depression severity with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating scale at baseline, and at 1 (D1), 2 (D2), and 7 (D7) days after dosing. RESULTS We observed significant antidepressant effects of ayahuasca when compared with placebo at all-time points. MADRS scores were significantly lower in the ayahuasca group compared with placebo at D1 and D2 (p = 0.04), and at D7 (p < 0.0001). Between-group effect sizes increased from D1 to D7 (D1: Cohen's d = 0.84; D2: Cohen's d = 0.84; D7: Cohen's d = 1.49). Response rates were high for both groups at D1 and D2, and significantly higher in the ayahuasca group at D7 (64% v. 27%; p = 0.04). Remission rate showed a trend toward significance at D7 (36% v. 7%, p = 0.054). CONCLUSIONS To our knowledge, this is the first controlled trial to test a psychedelic substance in treatment-resistant depression. Overall, this study brings new evidence supporting the safety and therapeutic value of ayahuasca, dosed within an appropriate setting, to help treat depression. This study is registered at http://clinicaltrials.gov (NCT02914769).
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Affiliation(s)
- Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal/RN, Brazil
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
| | - Dayanna Barreto
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
- Department of Clinical Medicine, UFRN, Natal/RN, Brazil
| | - Heloisa Onias
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal/RN, Brazil
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
| | - Katia C. Andrade
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal/RN, Brazil
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
| | - Morgana M. Novaes
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal/RN, Brazil
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
| | - Jessica A. Pessoa
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal/RN, Brazil
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
| | - Sergio A. Mota-Rolim
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal/RN, Brazil
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
| | - Flávia L. Osório
- Department of Neurosciences and Behaviour, University of São Paulo (USP), Ribeirão Preto/SP, Brazil
- National Institute of Science and Technology in Translational Medicine (INCT-TM), Ribeirão Preto/SP, Brazil
| | - Rafael Sanches
- Department of Neurosciences and Behaviour, University of São Paulo (USP), Ribeirão Preto/SP, Brazil
- National Institute of Science and Technology in Translational Medicine (INCT-TM), Ribeirão Preto/SP, Brazil
| | - Rafael G. dos Santos
- Department of Neurosciences and Behaviour, University of São Paulo (USP), Ribeirão Preto/SP, Brazil
- National Institute of Science and Technology in Translational Medicine (INCT-TM), Ribeirão Preto/SP, Brazil
| | - Luís Fernando Tófoli
- Department of Medical Psychology and Psychiatry, University of Campinas, Campinas/SP, Brazil
| | | | - Mauricio Yonamine
- Department of Clinical Analysis and Toxicology, USP, São Paulo/SP, Brazil
| | - Jordi Riba
- Sant Pau Institute of Biomedical Research, Barcelona, Spain
| | | | | | | | - Nicole L. Galvão-Coelho
- National Institute of Science and Technology in Translational Medicine (INCT-TM), Ribeirão Preto/SP, Brazil
- Department of Physiology, UFRN, Natal/RN, Brazil
| | - Bruno Lobão-Soares
- National Institute of Science and Technology in Translational Medicine (INCT-TM), Ribeirão Preto/SP, Brazil
- Department of Biophysics and Pharmacology, UFRN, Natal/RN, Brazil
| | - Jaime E. C. Hallak
- Department of Neurosciences and Behaviour, University of São Paulo (USP), Ribeirão Preto/SP, Brazil
- National Institute of Science and Technology in Translational Medicine (INCT-TM), Ribeirão Preto/SP, Brazil
| | - Emerson Arcoverde
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
- Department of Clinical Medicine, UFRN, Natal/RN, Brazil
- National Institute of Science and Technology in Translational Medicine (INCT-TM), Ribeirão Preto/SP, Brazil
| | - João P. Maia-de-Oliveira
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
- Department of Clinical Medicine, UFRN, Natal/RN, Brazil
- National Institute of Science and Technology in Translational Medicine (INCT-TM), Ribeirão Preto/SP, Brazil
| | - Dráulio B. Araújo
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal/RN, Brazil
- Onofre Lopes University Hospital, UFRN, Natal/RN, Brazil
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Silva LGD, Tófoli LF, Calheiros PRV. Tratamentos ofertados em Comunidades Terapêuticas: Desvelando práticas na Amazônia Ocidental. Estud psicol (Natal) 2018. [DOI: 10.22491/1678-4669.20180031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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25
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Cordeiro R, Luz VG, Hennington ÉA, Martins ACA, Tófoli LF. Urban violence is the biggest cause of fatal work-related accidents in Brazil. Rev Saude Publica 2017; 51:123. [PMID: 29236880 PMCID: PMC5718101 DOI: 10.11606/s1518-8787.2017051000296] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/23/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To quantify the occurrence of deaths directly associated with urban violence among fatal work-related accidents. METHODS Verbal autopsies were performed with the relatives and coworkers of residents of Campinas, state of São Paulo, Brazil, who died from external causes in 2015. We have also analyzed police reports and reports of the Legal Medical Institute related to these deaths. RESULTS We have identified 82 fatal work-related accidents in Campinas in 2015, of which 25 were murders, 35 were traffic accidents not directly related to work activities, and three were suicides at work. The proportional mortality rate for homicides, traffic accidents, and suicides among fatal work-related accidents was estimated at 30.5%, 42.7%, and 3.7%, respectively. CONCLUSIONS Urban violence accounted for three-fourths of the fatal work-related accidents recorded in the period studied.
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Affiliation(s)
- Ricardo Cordeiro
- Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Saúde Coletiva. Campinas, SP, Brasil
| | - Verônica Gronau Luz
- Universidade Federal da Grande Dourados. Faculdade de Ciências da Saúde. Curso de Nutrição. Dourados, MS, Brasil
| | - Élida Azevedo Hennington
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Centro de Estudos da Saúde do Trabalhador e Ecologia Humana. Rio de Janeiro, RJ, Brasil
| | - Ana Cláudia Alves Martins
- Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Programa de Pós-Graduação em Saúde Coletiva. Campinas, SP, Brasil
| | - Luís Fernando Tófoli
- Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Psicologia Médica e Psiquiatria. Campinas, SP, Brasil
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Schenberg EE, de Castro Comis MA, Alexandre JFM, Tófoli LF, Chaves BDR, da Silveira DX. A phenomenological analysis of the subjective experience elicited by ibogaine in the context of a drug dependence treatment. Journal of Psychedelic Studies 2017. [DOI: 10.1556/2054.01.2017.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | - Luís Fernando Tófoli
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
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Schenberg EE, de Castro Comis MA, Alexandre JFM, Chaves BDR, Tófoli LF, da Silveira DX. Treating drug dependence with the aid of ibogaine: A qualitative study. Journal of Psychedelic Studies 2017. [DOI: 10.1556/2054.01.2016.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | - Bruno Daniel Rasmussen Chaves
- Instituto Plantando Consciência, São Paulo, Brazil
- Hospital e Maternidade Maria Perpétua Piedade Gonçalves, Santa Cruz do Rio Pardo, Brazil
| | - Luís Fernando Tófoli
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
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Abstract
Despite reports of apparent benefits, social and political pressure beginning in the late 1960s effectively banned scientific inquiry into psychedelic substances. Covert examination of psychedelics persisted through the 1990s; the turn of the century and especially the past 10 years, however, has seen a resurgent interest in psychedelic substances (eg, LSD, ayahuasca, psilocybin). This chapter outlines relevant EEG and brain imaging studies evaluating the effects of psychedelics on the brain. This chapter also reviews evidence of the use of psychedelics as adjunct therapy for a number of psychiatric and addictive disorders. In particular, psychedelics appear to have efficacy in treating depression and alcohol-use disorders.
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Affiliation(s)
- L F Tófoli
- School of Medical Sciences, University of Campinas, Campinas, Brazil.
| | - D B de Araujo
- Brain Institute/Hospital Universitario Onofre Lopes, UFRN, Natal, Brazil
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29
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Brouwers EPM, Mathijssen J, Van Bortel T, Knifton L, Wahlbeck K, Van Audenhove C, Kadri N, Chang C, Goud BR, Ballester D, Tófoli LF, Bello R, Jorge-Monteiro MF, Zäske H, Milaćić I, Uçok A, Bonetto C, Lasalvia A, Thornicroft G, Van Weeghel J. Discrimination in the workplace, reported by people with major depressive disorder: a cross-sectional study in 35 countries. BMJ Open 2016; 6:e009961. [PMID: 26908523 PMCID: PMC4769412 DOI: 10.1136/bmjopen-2015-009961] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Whereas employment has been shown to be beneficial for people with Major Depressive Disorder (MDD) across different cultures, employers' attitudes have been shown to be negative towards workers with MDD. This may form an important barrier to work participation. Today, little is known about how stigma and discrimination affect work participation of workers with MDD, especially from their own perspective. We aimed to assess, in a working age population including respondents with MDD from 35 countries: (1) if people with MDD anticipate and experience discrimination when trying to find or keep paid employment; (2) if participants in high, middle and lower developed countries differ in these respects; and (3) if discrimination experiences are related to actual employment status (ie, having a paid job or not). METHOD Participants in this cross-sectional study (N=834) had a diagnosis of MDD in the previous 12 months. They were interviewed using the Discrimination and Stigma Scale (DISC-12). Analysis of variance and generalised linear mixed models were used to analyse the data. RESULTS Overall, 62.5% had anticipated and/or experienced discrimination in the work setting. In very high developed countries, almost 60% of respondents had stopped themselves from applying for work, education or training because of anticipated discrimination. Having experienced workplace discrimination was independently related to unemployment. CONCLUSIONS Across different countries and cultures, people with MDD very frequently reported discrimination in the work setting. Effective interventions are needed to enhance work participation in people with MDD, focusing simultaneously on decreasing stigma in the work environment and on decreasing self-discrimination by empowering workers with MDD.
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Affiliation(s)
- E P M Brouwers
- Department of Tranzo, Tilburg University, Tilburg, The Netherlands
| | - J Mathijssen
- Department of Tranzo, Tilburg University, Tilburg, The Netherlands
| | - T Van Bortel
- King's College London, Institute of Psychiatry, London, UK
| | - L Knifton
- Mental Health Foundation, Glasgow, UK
| | - K Wahlbeck
- National Institute for Health and Welfare, Vaasa, Finland
| | | | - N Kadri
- Ibn Rushd University Psychiatric Centre, Casablanca, Morocco
| | - Ch Chang
- Department of Psychiatry, Chi Mei Medical Centre, Tainan, Taiwan
| | - B R Goud
- St John's Medical College Hospital, St John's National Academy of Health Sciences, Bangalore, India
| | - D Ballester
- Sistema de Saúde Mãe de Deus, Porto Alegre, Brazil
| | - L F Tófoli
- Universidade Federal do Ceara, Campus Sobral, Brazil
| | - R Bello
- Hospital Universitario de Caracas, Caracas, Venezuela
| | | | - H Zäske
- Heinrich-Heine Universitat Dusseldorf, Rheinische Kliniken Dusseldorf, Germany
| | - I Milaćić
- Faculty for Special Education and Rehabilitation, Belgrade, Serbia
| | - A Uçok
- Foundation of Psychiatry Clinic of Medical Faculty of Istanbul, Istanbul, Turkey
| | - C Bonetto
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - A Lasalvia
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
| | - G Thornicroft
- King's College London, Institute of Psychiatry, London, UK
| | - J Van Weeghel
- Department of Tranzo, Tilburg University, Tilburg, The Netherlands
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de Jesus Mari J, Tófoli LF, Noto C, Li LM, Diehl A, Claudino AM, Juruena MF. Pharmacological and psychosocial management of mental, neurological and substance use disorders in low- and middle-income countries: issues and current strategies. Drugs 2013; 73:1549-68. [PMID: 24000001 DOI: 10.1007/s40265-013-0113-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Mental, neurological, and substance use disorders (MNS) are among the largest sources of medical disability in the world, surpassing both cardiovascular disease and cancer. The picture is not different in low- and middle-income countries (LAMIC) where the relative morbidity associated with MNS is increasing, as a consequence of improvement in general health indicators and longevity. However, 80 % of individuals with MNS live in LAMIC but only close to 20 % of cases receive some sort of treatment. The main aim of this article is to provide non-specialist health workers in LAMIC with an accessible guide to the affordable essential psychotropics and psychosocial interventions which are proven to be cost effective for treating the main MNS. The MNS discussed in this article were selected on the basis of burden, following the key priority conditions selected by the Mental Health Action Programme (mhGAP) developed by the World Health Organization (WHO) (anxiety, stress-related and bodily distress disorders; depression and bipolar disorder; schizophrenia; alcohol and drug addiction; and epilepsy), with the addition of eating disorders, because of their emergent trend in middle-income countries. We review best evidence-based clinical practice in these areas, with a focus on drugs from the WHO Model List of Essential Medicines and the psychosocial interventions available in LAMIC for the management of these conditions in primary care. We do this by reviewing guidelines developed by prestigious professional associations and government agencies, clinical trials conducted in LAMIC and systematic reviews (including Cochrane reviews) identified from the main international literature databases (MEDLINE, EMBASE and PsycINFO). In summary, it can be concluded that the availability and use of the psychotropics on the WHO Model List of Essential Medicines in LAMIC, plus an array of psychosocial interventions, can represent a cost-effective way to expand treatment of most MNS. The translation of these findings into policies can be achieved by relatively low supplementary funding, and limited effort engendered by governments and policy makers in LAMIC.
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Affiliation(s)
- Jair de Jesus Mari
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Borges Lagoa 570 - 1° andar, Vila Clementino, São Paulo, SP, 04038-000, Brazil,
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Gonçalves DA, Fortes S, Tófoli LF, Campos MR, Mari JDJ. Determinants of common mental disorders detection by general practitioners in primary health care in Brazil. Int J Psychiatry Med 2011; 41:3-13. [PMID: 21495518 DOI: 10.2190/pm.41.1.b] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Common mental disorders (CMD) are highly prevalent among patients attending primary care. Many of these disorders remain unrecognized by general practitioners (GPs), with the detection rates varying from 30 to 60%. This study aims to evaluate the CMD detection rates by Primary Heath Care (PHC) practitioners in Brazil-and factors that affect CMD detection. METHODS A cross sectional study was conducted with users of five PHC units in the city of Petrópolis. The CMD prevalence of psychiatric morbidity was estimated by the General Health Questionnaire-12, and the physician's CMD detection was evaluated by a questionnaire completed by GPs after each consultation. RESULTS Seven hundred and fourteen subjects participated of the study, and 400 (56%) were screened positive using GHQ-12 cut-off point of 2/3. GPs diagnosed 379 people with CMD (53.1%), and 256(36%) subjects were detected by both GHQ and the GPs with an OR of 3.04 (95% CI 2.23-4.13). CMD detection accuracy by GPs was 65%. There was a strong association between the detection of CMD and the report of medically unexplained physical symptoms by GPs. Being female, married, and a frequent service user was also related to higher detection rates. CONCLUSION CMD detection rate was similar to those reported worldwide, but contrary to other studies, the presence of MUS increased detection rates. The high frequency of CMD in Primary Health Care highlights the need for improving GP and health worker's training in order to enable them to accurately recognize and treat psychological distress with evidence-based interventions.
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Tófoli LF, Andrade LH, Fortes S. Somatização na América Latina: uma revisão sobre a classificação de transtornos somatoformes, síndromes funcionais e sintomas sem explicação médica. Rev Bras Psiquiatr 2011; 33 Suppl 1:S59-80. [DOI: 10.1590/s1516-44462011000500006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Os sintomas sem explicação médica são frequentes e estão associados a sofrimento mental em vários contextos. Estudos prévios apontam que as populações latino-americanas são propensas à somatização. Diante da reformulação da Classificação Internacional de Doenças para sua 11ª edição, as particularidades dos nativos desta região do mundo devem ser levadas em consideração. O objetivo deste estudo é prover informações sobre somatização na população latino-americana para a tomada de decisões quanto às categorias diagnósticas ligadas a sintomas sem explicação médica na Classificação Internacional de Doenças-11ª edição. MÉTODO: Revisão extensa da produção de 1995 a 2011 sobre somatização em populações de origem latino-americana. RESULTADOS: A análise dos 106 estudos incluídos nesta revisão foi dividida em 15 categorias: revisões sistemáticas, revisões conceituais, prevalências, atenção primária, depressão e ansiedade, fatores de risco, violência, quadros orgânicos, relacionamento com profissionais e o sistema de saúde, etnia, síndromes ligadas à cultura, síndrome da fadiga crônica, fibromialgia, transtorno dismórfico corporal, e conversão e dissociação. CONCLUSÃO: Os estudos latino-americanos confirmam a dificuldade na definição categorial de quadros com sintomas sem explicação médica. O suposto "traço somatizador" das culturas latinas pode estar associado mais à expressão cultural e linguística do que a um caráter de natureza étnica, e tais particularidades devem estar na agenda na nova classificação destes fenômenos na Classificação Internacional de Doenças-11ª edição.
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Alexandrino-Silva C, Alves TF, Tófoli LF, Wang YP, Andrade LH. Psychiatry: life events and social support in late life depression. Clinics (Sao Paulo) 2011; 66:233-8. [PMID: 21484039 PMCID: PMC3059858 DOI: 10.1590/s1807-59322011000200009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Revised: 09/20/2010] [Accepted: 11/03/2010] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To examine the association of life events and social support in the broadly defined category of depression in late life. INTRODUCTION Negative life events and lack of social support are associated with depression in the elderly. Currently, there are limited studies examining the association between life events, social support and late-life depression in Brazil. METHODS We estimated the frequency of late-life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors. ''Old age symptomatic depression'' was defined using the Composite International Diagnostic Interview 1.1 tool. This diagnostic category included only late-life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression, termed ''late subthreshold depression''. Social support and life events were assessed using the Comprehensive Assessment and Referral Evaluation (SHORT-CARE) inventory. RESULTS ''Old age symptomatic depression'' occurred in 18.8% of the patients in the tested sample. In univariate analyses, this condition was associated with female gender, lifetime anxiety disorder and living alone. In multivariate models, ''old age symptomatic depression'' was associated with a perceived lack of social support in men and life events in women. DISCUSSION Social support and life events were determined to be associated with late-life depression, but it is important to keep in mind the differences between genders. Also, further exploration of the role of lifetime anxiety disorder in late-life depression may be of future importance. CONCLUSIONS We believe that this study helps to provide insight into the role of psychosocial factors in late-life depression.
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Affiliation(s)
- Clóvis Alexandrino-Silva
- Section of Psychiatry Epidemiology, Institute and Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil.
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Tófoli LF. [Are more persons with mental disorders dying due to fewer mental hospitals in Brazil?]. Braz J Psychiatry 2008; 30:170-2. [PMID: 18592112 DOI: 10.1590/s1516-44462008000200018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
The objective of the present study was to determine the frequency at which people complain of any type of headache, and its relationship with sociodemographic characteristics and psychiatric comorbidity in S o Paulo, Brazil. A three-step cluster sampling method was used to select 1,464 subjects aged 18 years or older. They were mainly from families of middle and upper socioeconomic levels living in the catchment area of Instituto de Psiquiatria. However, this area also contains some slums and shantytowns. The subjects were interviewed using the Brazilian version of the Composite International Diagnostic Interview version 1.1. (CIDI 1.1) by a lay trained interviewer. Answers to CIDI 1.1 questions allowed us to classify people according to their psychiatric condition and their headaches based on their own ideas about the nature of their illness. The lifetime prevalence of "a lot of problems with" headache was 37.4% (76.2% of which were attributed to use of medicines, drugs/alcohol, physical illness or trauma, and 23.8% attributed to nervousness, tension or mental illness). The odds ratio (OR) for headache among participants with "nervousness, tension or mental illness" was elevated for depressive episodes (OR, 2.1; 95%CI, 1.4-3.4), dysthymia (OR, 3.4; 95%CI, 1.6-7.4) and generalized anxiety disorder (OR, 4.3; 95%CI, 2.1-8.6), when compared with patients without headache. For "a lot of problems with" headaches attributed to medicines, drugs/alcohol, physical illness or trauma, the risk was also increased for dysthymia but not for generalized anxiety disorder. These data show a high association between headache and chronic psychiatric disorders in this Brazilian population sample.
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Affiliation(s)
- I M Benseñor
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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