Cited by 6Psychedelics and Drug StudiesCancer survivorship and careReligion, Spirituality, and Psychology

Innovations in group-based psilocybin-assisted therapy of major depression in patients with cancer

Open access
Thrul, Johannes, Kozak, Zofia, Carducci, Michael A., Garcia‐Romeu, Albert, Yaden, David B.·2024·Cancer

Abstract

Several recent studies have investigated psilocybin as a novel therapeutic compound for the treatment of existential distress in patients with cancer, demonstrating persistent, positive effects on mood. This editorial discusses two articles in the current issue of Cancer that report findings of a group‐based psilocybin‐assisted intervention for treatment of depression in patients diagnosed with cancer.

Integrity signals

Registry

Crossref · 10.1002/cncr.35127

Cites

20 of 20 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

21 of 27 cited sources checked · 15 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    A blinded, placebo-controlled study found comparable reductions in depression, anxiety, and stress in participants in group-based ceremonies whether they received ayahuasca or placebo.

    “These findings are consistent with results from a blinded, placebo-controlled study (N = 30) demonstrating that participants in group-based ceremonies showed comparable reductions in depression, anxiety, and stress whether they received ayahuasca or placebo, indicating a potential therapeutic effect of the groupbased ceremony in itself.13”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [13] 13. Uthaug MV, Mason NL, Toennes SW, et al. A placebo-controlled study of the effects of ayahuasca, set and setting on mental health of participants in ayahuasca group retreats. Psychophar- macology (Berl). 2021;238(7):1899-1910. doi:10.1007/s00213-021- 05817-8 source
  • Premisecitation

    Research in healthy participants suggests that group-based aftercare in addition to standard 2-on-1 support models can amplify well-being benefits of individual high-dose psilocybin sessions.

    “Similarly, research in healthy participants (N = 75) suggests group-based aftercare in addition to standard 2-on-1 support models can amplify well-being benefits of individual high-dose psilocybin sessions.11”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [11] 11. Griffiths RR, Johnson MW, Richards WA, et al. Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psycholog- ical functioning and in trait measures of prosocial attitudes and be- haviors. J Psychopharmacol Oxf Engl. 2018;32(1):49-69. doi:10.1177/ 0269881117731279 source

      The Methods (Study design and overview; Guide–participant meetings and support for spiritual practice; page unavailable) describe 75 healthy participants, individual sessions with two guides, and additional dialogue-group meetings in the high-support condition. The Results (Persisting effects assessed at the 6-month follow-up; page unavailable) report greater positive effects on some measures in the high-dose/high-support group than in the high-dose/standard-support group. But high support also involved substantially more individual guide meetings, so the study does not isolate group-based aftercare as the reason for amplified benefits. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Premisecitation

    The phase 2 trial reported a significant reduction in depression scores from baseline to 8-week follow-up.

    “The study reported a significant reduction in depression scores from baseline to 8-week followup.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [14] 14. Agrawal M, Richards W, Beaussant Y, et al. Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder. Cancer. 2023. doi:10.1002/cncr.35010 source
  • Premisecitation

    In the phase 2 trial, a sustained response was observed in 80% of patients at 8-week follow-up.

    “A sustained response was observed in 80% of patients and full remission of depressive symptoms observed in 50% of patients at 8week follow-up.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [14] 14. Agrawal M, Richards W, Beaussant Y, et al. Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder. Cancer. 2023. doi:10.1002/cncr.35010 source
  • Premisecitation

    Both articles in the current issue are based on a phase 2 open-label trial (N = 30) assessing the impact of single-dose psilocybin on depressive symptoms among patients with cancer and major depressive disorder.

    “Both articles are based on a phase 2 open-label trial (N = 30) assessing the impact of single-dose psilocybin on depressive symptoms among patients with cancer and major depressive disorder.14”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [14] 14. Agrawal M, Richards W, Beaussant Y, et al. Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder. Cancer. 2023. doi:10.1002/cncr.35010 source
  • Classified as probably not a substantial claim. 12
  • May combine two claims. 6
  • Classified as probably not a substantial claim.

    Premisecitation

    A British study concluded that psilocybin for treatment of depression can be cost-effective compared to established treatments (SSRIs, CBT) only if therapist costs were reduced by 25%-50%.

    “whereas a British study concluded that psilocybin for treatment of depression can be cost-effective compared to established treatments of depression (selective serotonin reuptake inhibitors, cognitive behavioral therapy) only if therapist costs were reduced by 25%-50% 19”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [19] 19. McCrone P, Fisher H, Knight C, et al. Cost-effectiveness of psilocybin- assisted therapy for severe depression: exploratory findings from a decision analytic model. Psychol Med. 2023:1-8. Published online June 2. doi:10.1017/S0033291723001411 source

      The Results report that, from a societal perspective, psilocybin met the £30,000 cost-effectiveness threshold against medication alone or psychological therapy alone at a drug cost of £400 per person, without stating that therapist costs had to be reduced. The paper also finds cost-effectiveness in scenarios with 25%–50% lower therapist-support costs, but those reductions are not an 'only if' condition. (LLM, conf=0.86)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Group preparation and aftercare for individual psilocybin dosing sessions can be feasibly implemented in older long-term AIDS survivor men, with persisting reductions in demoralization up to 3 months after the intervention.

    “Previous research has found that group preparation and aftercare for individual psilocybin dosing sessions can be feasibly implemented in clinical populations such as older long-term AIDS survivor men (N = 18), who showed persisting reductions in demoralization up to 3 months after the intervention.10”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] 10. Anderson BT, Danforth A, Daroff PR, et al. Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: an open-label safety and feasibility pilot study. EClinicalMedicine. 2020; 27:100538. doi:10.1016/j.eclinm.2020.100538 source
  • May combine two claims.

    Premisecitation

    Participants in the qualitative study reported overall positive experiences with the group format, mirroring the improvement in quantitative outcomes.

    “Participants reported overall positive experiences with the group format, mirroring the improvement in quantitative outcomes.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [15] 15. Beaussant Y, Tarbi E, Nigam K, et al. Acceptability of psilocybin- assisted group therapy in patients with cancer and major depres- sive disorder: qualitative analysis. Cancer. 2023. doi:10.1002/cncr. 35024 source
  • May combine two claims.

    Premiseown data

    In the phase 2 trial, there was an absence of serious adverse events (SAEs) or suicidality.

    “Also notable was the absence of serious adverse events (SAEs) or suicidality, as concerns have emerged following reports of SAEs in a recent large trial on psilocybin for treatmentresistant depression.6”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [14] 14. Agrawal M, Richards W, Beaussant Y, et al. Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder. Cancer. 2023. doi:10.1002/cncr.35010 source

      The Safety section reports no suicidality and no serious adverse events attributed to psilocybin. The citing sentence omits that attribution qualifier, so the paper does not establish an absence of serious adverse events from any cause. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • May combine two claims.

    Premisecitation

    Specific benefits of the group format mentioned by participants included a feeling of safety and preparedness and a sense of connection to others in the group that may have supported treatment outcomes.

    “Specific benefits of the group format mentioned by participants included a feeling of safety and preparedness and a sense of connection to others in the group that may have supported treatment outcomes.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [15] 15. Beaussant Y, Tarbi E, Nigam K, et al. Acceptability of psilocybin- assisted group therapy in patients with cancer and major depres- sive disorder: qualitative analysis. Cancer. 2023. doi:10.1002/cncr. 35024 source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Racial and/or ethnic diversity of participants was relatively low in the trial in question, similar to other psilocybin studies.

    “Racial and/or ethnic diversity of participants was relatively low in the trial in question, similar to other psilocybin studies, and no information on income was provided.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] 14. Agrawal M, Richards W, Beaussant Y, et al. Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder. Cancer. 2023. doi:10.1002/cncr.35010 source

      The Discussion identifies a lack of diversity or representation as a limitation, and Table 1 reports that 80% of participants were Caucasian. The paper does not compare its participants’ racial or ethnic diversity with that of other psilocybin studies, so the comparison is not supported by this source. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    No information on income was provided in the trial.

    “Racial and/or ethnic diversity of participants was relatively low in the trial in question, similar to other psilocybin studies, and no information on income was provided.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] 14. Agrawal M, Richards W, Beaussant Y, et al. Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder. Cancer. 2023. doi:10.1002/cncr.35010 source
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Therapeutic support accompanying psilocybin treatment has received less attention as a possible therapeutic mechanism in the published literature.

    “psilocybin treatment is commonly accompanied by therapeutic support (specifically in the form of preparatory sessions, nondirected support during drug dosing, and aftercare), which has received less attention as a possible therapeutic mechanism in the published literature.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    In the psychedelic research context, accounting for dependencies of participants clustered in groups would be exceedingly difficult due to the costs involved.

    “However, the psychedelic research context would make that exceedingly difficult due to the costs involved.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    The assumption of independence of observations is due to the potential for participants within a group to influence one another beneficially or detrimentally.

    “This assumption is part of most statistical tools and is due to the potential for participants within a group to influence one another beneficially or detrimentally, and thus statistical tests should account for dependencies of individual participants clustered in groups.20”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] 20. Baldwin SA, Murray DM, Shadish WR. Empirically supported treat- ments or type I errors? Problems with the analysis of data from group- administered treatments. J Consult Clin Psychol. 2005;73(5):924-935. doi:10.1037/0022-006X.73.5.924 source
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    A unique risk of group-based therapy may be the juxtaposition of experiences and subsequent disillusionment among those patients who did not have profound experiences or did not improve as much as others.

    “A unique risk of group-based therapy may be the juxtaposition of experiences and subsequent disillusionment among those patients who did not have profound experiences or did not improve as much as others.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Statistical tests should account for dependencies of individual participants clustered in groups.

    “This assumption is part of most statistical tools and is due to the potential for participants within a group to influence one another beneficially or detrimentally, and thus statistical tests should account for dependencies of individual participants clustered in groups.20”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] 20. Baldwin SA, Murray DM, Shadish WR. Empirically supported treat- ments or type I errors? Problems with the analysis of data from group- administered treatments. J Consult Clin Psychol. 2005;73(5):924-935. doi:10.1037/0022-006X.73.5.924 source
  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    The primary advantage of the group-based format is that it reduces staffing costs and therefore could increase access.

    “The primary advantage of this format is that it reduces staffing costs and therefore could increase access.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    We currently do not have evidence for who is a good candidate for group-based versus individual psilocybin therapy.

    “We currently do not have evidence for who is a good candidate for group-based versus individual psilocybin therapy.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    The assumption of independence of observations is part of most statistical tools.

    “This assumption is part of most statistical tools and is due to the potential for participants within a group to influence one another beneficially or detrimentally, and thus statistical tests should account for dependencies of individual participants clustered in groups.20”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] 20. Baldwin SA, Murray DM, Shadish WR. Empirically supported treat- ments or type I errors? Problems with the analysis of data from group- administered treatments. J Consult Clin Psychol. 2005;73(5):924-935. doi:10.1037/0022-006X.73.5.924 source
15 of 15
  • The paper relies on this without support.

    Psychotherapeutic support for psilocybin treatment has typically been provided to each participant to ensure safety, with two facilitators required for the psilocybin administration session that may last up to 10 hours.

    “This psychotherapeutic support has been typically provided to each participant to ensure safety, with two facilitators required for the psilocybin administration session that may last up to 10 hours.”
  • The paper relies on this without support.

    Group-based administration of psychedelic compounds is common in some Indigenous ritualistic psychedelic use and underground contexts.

    “Moreover, group-based administration of psychedelic compounds is common in some Indigenous ritualistic psychedelic use and underground contexts, pointing to a mode of administration that others have found beneficial outside of the medical context.”
2 of 2

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Authors
Thrul, J., Kozak, Z., Carducci, M. A., Garcia‐Romeu, A., & Yaden, D. B.
Affiliations
  • Johns Hopkins University (US)
  • University of Maryland, Baltimore (US)
Corresponding author
Thrul, Johannes
Venue
Cancer
Publisher
Wiley
Published
2023-12-18
Volume
130
Issue
7
Pages
1028-1030
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
OpenAlex
W4389895405
Cited by
6
References
20
Citations by year
2026: 3 · 2025: 1 · 2024: 2
Type
journal article
Language
en
Open access
Locations
  • Cancer (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Johns Hopkins University
  • Steven and Alexandra Cohen Foundation
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Health › Religion, Spirituality, and Psychology
Keywords
psilocybin, psilocybin-assisted therapy, major depressive disorder, cancer patients, group intervention, existential suffering, mood, psychedelic therapy
MeSH terms
Anxiety, Depression, Major Depressive Disorder, Humans, Neoplasms, Psilocybin

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